重复高频经颅磁刺激治疗抑郁的临床研究  

Clinical study on repeated high-frequency transcranial magnetic stimulation in treatment of depression

作　　者：陈葵[1] 肖玉莲[1] 李秀华[1] 齐冬[1] 曲媛[1] 

机构地区：[1]首都医科大学附属北京友谊医院神经内科,北京100050

出　　处：《临床和实验医学杂志》2017年第1期88-90,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察重复高频经颅磁刺激治疗抑郁的安全性和有效性。方法选取符合入组标准的门诊抑郁患者78例,随机化分为治疗组(39例)和对照组(39例)。在常规抗抑郁药治疗基础上治疗组使用重复高频经颅磁刺激,对照组使用不引起大脑皮层神经细胞的去极化的伪线圈进行刺激。刺激部位:左侧前额叶背外侧区。刺激频率为10Hz,刺激强度为100%MT,单次刺激持续时间3 s,间隔20 s,共刺激80次,总刺激时间30 min 20 s。每天一次,连续治疗5 d后休息2 d,再治疗5 d结束。共治疗10次。比较两组治疗前后的汉密尔顿抑郁量表,实验室检查的改变以及不良事件。结果治疗组脱落2例,对照组脱落4例。治疗组有效率(97.3%)显著高于对照组(82.9%)(χ~2=4.27,P=0.039<0.05),其中治疗组较对照组能够显著改善兴趣减退和睡眠,而对抑郁情绪、焦虑、有罪感和自杀没有明显的改善作用。治疗组发生不良事件3例,对照组2例,均为轻中度,经对症处理后完全消失,两组不良事件发生率比较无显著性差异(P>0.05)。实验室检查未见明显异常改变。结论重复高频经颅磁刺激治疗抑郁安全、有效。Objective To confirm the effectiveness and safety of repeated high frequency transcranial magnetic stimulator in treatment of depression. Methods A total of 78 out- patients met the criteria of depression were enrolled and they were randomly classified as trial group（ 39cases） and control group（ 39 cases）. Patients in these two groups were treated on the basis of routine antidepressant treatment. Patients in trial group were applied with repeated high frequency transcranial magnetic stimulation while patients in control group were used with pseudo coil stimulation which did not induce the depolarization of nerve cells in cerebral cortex. The stimulation site was in left prefrontal dorsolateral area,with frequency at 10 Hz and stimulation intensity at 100% MT,the duration for single stimulus was 3 seconds with interval of 20 seconds and the total stimuli were 80 times,and the whole duration for stimulus was 30 minutes and 20 seconds. Continuous treatment was carried out once a day for five days after rest for 2 days,then ended treatment for another five days. Hamilton depression rating scale had been applied for comparison of patients in these 2 groups before and after treatment,changes in laboratory examinations and adverse events were also compared. Results Two patients in trial group and 4 patients in control group withdrew from the treatment course. The efficacy of trial group（ 97. 3%） was significantly higher than that（ 82. 9%） of control group（ χ~2= 4. 27,P = 0. 039 0. 05）,patients in trial group can significantly improve their interest and sleep,but they did not get improvement in depression,anxiety,sense of guilty and suicide. Adverse events occurred in 3 patients of trial group and 2 patients in control group. Adverse events were mild to moderate and disappeared completely after the treatment. There was no significant difference between these two groups. Indices of laboratory examination did not significantly change in these two groups. Conclusion The application of repeated high freq

关 键 词：抑郁 重复高频 经颅磁刺激 

分 类 号：R749.4[医药卫生—神经病学与精神病学]