重复经颅磁刺激合并米氮平治疗人类免疫缺陷病毒感染伴发抑郁症患者的对照研究  

A control study of repeated transcranial magnetic stimulation combined with mirtazapine in treatment of human immunodeficiency virus infection patients with depression

作　　者：李启斌 杨景毅[3] 陶领钢 田群 韦波 李巧玲 黄斌 于海 李海林 黄夏昉 刘训 LI Qi-bin;YANG Jing-yi;TAO Ling-gang;TIAN Qun;WEI Bo;LI Qiao-ling;HUANG Bin;YU Hai;LI Hai-lin;HUANG Xia-fang;LIU Xun(Guilin Mental Health Center,Guangxi 541001,China)

机构地区：[1]广西桂林市精神卫生中心(桂林市社会福利医院),541001 [2]桂林医学院精神心理卫生学教研室 [3]广西桂林市第三人民医院感染科

出　　处：《临床精神医学杂志》2019年第4期261-263,共3页Journal of Clinical Psychiatry

基　　金：桂林市科学研究与技术开发计划项目(20170109-43)

摘　　要：目的:探讨重复经颅磁刺激(rTMS)联合米氮平治疗人类免疫缺陷病毒(HIV)感染(PLWH)伴发抑郁症患者的疗效和安全性。 方法:90例PLWH伴抑郁症患者按照简单随机化方法分为研究组(45例)和对照组(45例),两组患者均采用米氮平抗抑郁治疗;研究组在此基础上联合低频rTMS治疗(20min/d,5次/周),疗程8周。治疗前及治疗1、2、4、8周后进行汉密尔顿抑郁量表(HAMD)及治疗中出现的症状量表(TESS)评定,以HAMD减分率≥50为有效。结果:两组患者均完成治疗,治疗后两组HAMD得分均随治疗时间明显下降,时间效应显著(F=12.03,P<0.001);组别效应显著(F=35.13,P<0.001);治疗后两组有效率均随着治疗时间而增加(U=8.25,P<0.001);治疗8周后研究组有效率(86.67%)显著高于对照组(66.67%)(χ^2=10.47,P<0.001);两组间不良反应发生率差异无统计学意义(χ^2=1.32,P>0.05)。 结论:rTMS合并米氮平治疗PLWH伴抑郁症患者疗效优于单一米氮平用药,且安全性高。Objective: To investigate effect and safety of repetitive transcranial magnetic stimulation(rTMS) combing with mirtazapine in treatment of human immunodeficiency virus(HIV) infective patients (PLWH) with depression. Method: Ninety patients with PLWH and depression were enrolled.According to simple randomization method,the patients were divided into two groups which included study group (n=45) and control group (n=45).Both groups were treated with mirazapine and the study group was treated additionally with rTMS (20 min/d,5 times/week) for 8 weeks.The efficacy and safety were assessed with Hamilton depression rating scale (HAMD) and treatment emergent symptom scale (TESS) before treatment and after 1,2,4,and 8 weeks of treatment.The HAMD reduction rate ≥50 was regarded as therapeutic efficacy. Results: After 8 weeks of treatment,the HAMD scores decreased in the two groups.There was significant time effect ( F=12.03,P <0.001) and group effect ( F=35.13,P <0.001).The effective rates of the two groups increased with treatment ( U=8.25,P <0.001).The study group showed more improvement rate (88.89%) than the control group (66.67%)(χ 2=10.47, P <0.001).The difference of adverse reaction rate between the two groups was not significant (χ 2=1.32, P >0.05). Conclusion: rTMS combined with mirtazapine is more effective than single mirtazapine for PLWH patients with depression,and the adverse reactions are similar to mirtazapine.

关 键 词：人类免疫缺陷病毒感染 抑郁症 重复经颅磁刺激 米氮平 

分 类 号：R749.4[医药卫生—神经病学与精神病学]