舍曲林联合重复经颅磁刺激对老年2型糖尿病患者伴抑郁的疗效观察  

Effect of sertraline combined with repetitive transcranial magnetic stimulation on depression in elderly patients with type 2 diabetes mellitus

作　　者：李素军[1] 李伟芳[1] 杨磊[1] 李媛媛[1] LI Sujun;LI Weifang;YANG Lei;LI Yuanyuan(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2021年第3期208-213,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省重大公益性项目[编号:HNZB(2010)N91号]。

摘　　要：目的观察舍曲林联合重复经颅磁刺激(rTMS)对老年2型糖尿病伴抑郁患者的治疗效果。方法选择2017-05—2020-08郑州大学第一附属医院老年内分泌科老年2型糖尿病伴抑郁患者120例,根据抛硬币法随机分为舍曲林联合重复经颅磁刺激组(联合组)和舍曲林单药治疗组(单药组)各60例,观察8周,联合组随访到53例,单药组随访到54例。对比2组治疗前后抗抑郁治疗有效率、汉密顿抑郁量表(HAMD-17)评分、服药依从性量表(MMAS-8)评分、中文版老年糖尿病自我管理行为量表(DSMB-O)评分和副反应量表(TESS)评分。结果治疗后2组有效率、MMSA-8、DSMB-O评分均随治疗时间的延长而增加,联合组增加幅度高于单药组,差异均有统计学意义(P<0.05)。治疗后2组HAMD-17评分均随治疗时间的延长而下降,联合组下降幅度高于单药组,差异均有统计学意义(P<0.05)。治疗后2组TESS评分差异无统计学意义(P>0.05)。结论rTMS能够增强舍曲林对老年2型糖尿病伴抑郁患者的抗抑郁效果,同时能够增加患者的服药依从性和自我管理能力。Objective To investigate the therapeutic effect of sertraline combined with repetitive transcranial magnetic stimulation(rTMS)in elderly patients with type 2 diabetes mellitus and depression.Methods From May 2017 to August 2020,120 elderly patients with type 2 diabetes mellitus and depression in the First Affiliated Hospital of Zhengzhou University were randomly divided into sertraline combined with repetitive transcranial magnetic stimulation group(combined group)and sertraline monotherapy group(single drug group),60 cases in each group.After 8 weeks of observation,53 cases were followed up in combination group and 54 cases in single drug group.The effective rate of antidepressant treatment,HAMD-17 scores,MMAS-8 scores,DSMB-O scores and TESS scores were compared between the two groups.Results After treatment,the effective rate,MMAS-8 and DSMB-O scores of the two groups increased with the extension of treatment time,and the increase rate of the combined group were higher than that of the single drug group(P<0.05).The HAMD-17 scores of the two groups decreased with the extension of treatment time,and the decline rate of the combined group was higher than that of the single drug group(P<0.05).There was no significant difference in TESS scores between the two groups after treatment(P>0.05).Conclusion rTMS can enhance the antidepressant effect of sertraline in elderly patients with type 2 diabetes mellitus and depression,and increase the medication compliance and self-management of patients.

关 键 词：抑郁症 2型糖尿病 老年 重复经颅磁刺激 舍曲林 

分 类 号：R749.92[医药卫生—神经病学与精神病学]