低频重复经颅磁刺激联合咪氮平治疗广泛性焦虑障碍的临床对照研究  

Clinical comparative study of generalized anxiety disorder treated with low-frequency repetitive transcranial magnetic stimulation combined with mirtazapine

作　　者：伍晓凡[1] 刘立志[1] 梁学军[1] 

机构地区：[1]解放军91医院全军精神疾病防治研究所,河南焦作454003

出　　处：《实用医药杂志》2016年第12期1064-1066,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的评价低频重复经颅磁刺激（rTMS）联合咪氮平片对广泛性焦虑障碍的临床疗效和安全性。方法将64例符合广泛性焦虑障碍诊断的患者（GAD）随机分为研究组（rTMS真刺激联合咪氮平片,36例）和对照组（rTMS假刺激联合咪氮平片,28例）,两组疗程均为6周。在治疗前及治疗后2、4、6周末予HAMA、CGI、TESS量表评定临床疗效和不良反应。结果研究组和对照组HAMA和CGI评分在2周末均已明显起效（P〈0.05或0.01）,但两组之间无显著性差异（P〉0.05）;4周末、6周末两组之间存在非常显著性差异（P〈0.01）;6周末,研究组有效率86.1%明显高于对照组（64.3%）（χ~2=4.182,P=0.048）;两组不良反应主要为恶心、口干、头晕、手动和心电图改变,但无显著性差异（χ~2=0.103,P=0.749）。结论重复经颅磁刺激（r TMS）辅助治疗广泛性焦虑障碍能够缩短起效时间,提高患者的依从性,远期疗效显著,同时无明显不良反应,值得临床推广应用。Objective To evaluate clinical efficacy and safety of low-frequency repetitive transcranial magnetic stimulation（rTMS） combined with mirtazapine tablets in the treatment of generalized anxiety disorder.Methods The 64 patients who met the diagnosis of generalized anxiety disorder（GAD） were divided into study group（rTMS real exciting joint mirtazapine tablets,36 cases） and control group（rTMS sham stimulation and mirtazapine tablets,28 cases）,and above treatment lasted six weeks. Before treatment and at the end of 2,4,6 weeks after treatment clinical efficacy and adverse reactions were evaluated with HAMA,CGI and TESS scale.Results HAMA and CGI scores at the end of two week study group and control group all had significant onset（P〈0.05 or 0.01）,but there was no significant difference between the two groups（P 〉0.05）. At the end of 4,6 weeks,there was significant difference between two groups（P〈0.01）. At the end of 6 weeks,the effective rate of study group was 86.1%,which was significantly higher than control group（64.3%）（χ~2=4.182,P =0.048）. Both group’s main nausea,xerostomia,dizziness,had movement and ECG changes,but there were no significant difference（χ~2=0.103,P =0.749）. Conclusion Repetitive transcranial magnetic stimulation（rTMS） treatment is possible to shorten onset time to generalized anxiety disorder,to improve patient’s compliance,has significant long-term effect,and no significant adverse reaction,which is worthy of clinical application.

关 键 词：低频重复经颅磁刺激 咪氮平片 广泛性焦虑障碍 临床疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]