rTMS联合药物治疗青少年首发重度抑郁发作临床研究  

Clinical Study of rTMS Combined with Drugs in the Treatment of Adolescents with First-episode Major Depressive Episode

作　　者：邱虹[1] 周保[1] 薛永合 吴锦荣 QIU Hong;ZHOU Bao;XUE Yonghe;WU Jinrong(Yinchuan First People's Hospital,Yinchuan 750004,China)

机构地区：[1]银川市第一人民医院,银川750004

出　　处：《宁夏医科大学学报》2021年第10期1017-1020,共4页Journal of Ningxia Medical University

基　　金：宁夏医科大学校级科研项目(201XM2019166)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合药物治疗青少年首发重度抑郁发作的临床效果。方法选取银川市第一人民医院门诊首发重度抑郁发作青少年患者100例(其中不伴有精神病性症状的重度抑郁发作青少年患者70例,伴有精神病性症状的重度抑郁发作青少年患者30例),采用随机数表法分成常规治疗组和联合治疗组。常规治疗组给予抗抑郁、抗精神病药物治疗;联合治疗组在上述药物治疗的基础上联合rTMS治疗。两组患者分别在治疗前、治疗2、4和8周后采用汉密尔顿抑郁量表24项版(HAMD-24)、症状自评量表(SCL-90)、简明精神病量表(BPRS,伴有精神病性症状的重度抑郁发作青少年患者加测)进行评估。结果联合治疗组患者在治疗2、4和8周后,HAMD-24评分、SCL-90抑郁因子T分均低于同期常规治疗组(P均<0.05);伴有精神病性症状的青少年患者,联合治疗组的精神症状缓解优于常规治疗组(P均<0.05)。研究结束后联合治疗组患者总有效率(94%)高于常规治疗组(76%)(χ^(2)=9.360,P<0.05)。结论rTMS联合药物治疗首发重度抑郁发作青少年患者,对比常规药物治疗能够更好地改善患者抑郁情绪,更有效改善精神病性症状,治愈率较高。Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with drugs in the treatment of adolescents with first episode of major depression.Methods A total of 100 adolescent patients with first episode of major depressive episode(including 70 adolescent patients with major depressive episode without psychotic symptoms and 30 adolescent patients with major depressive episode with psychotic symptoms)were selected from the outpatient department of our hospital.They were divided into conventional treatment group and combined treatment group by random number table method.The conventional treatment group was treated with antidepressant and antipsychotic drugs.The combined treatment group was combined with rTMS therapy on the basis of the above-mentioned drug therapy.The Hamilton depression scale-24 item(HAMD-24),the symptoms self rating scale(SCL-90)and the brife psychiatric rating scale(BPRS)were used to evaluate the two groups before,2,4 and 8 weeks after treatment,respectively.Results After 2,4 and 8 weeks of treatment,HAMD-24 scores and T score of SCL-90 depression factor in the combined treatment group were significantly lower than those in the conventional treatment group(P all<0.05);In adolescent patients with psychotic symptoms,the relief of psychotic symptoms in the combined treatment group was significantly better than that in the conventional drug treatment group(P all<0.05).After the end of the study,the total effective rate of the combined treatment group was 94%,which was 76%higher than that of the conventional treatment group(χ^(2)=9.360,P<0.05).Conclusion Compared with conventional drug therapy,rTMS combined with drug therapy can better improve the depressive mood and psychotic symptoms of adolescents with first episode of major depressive episode,with a higher cure rate.

关 键 词：RTMS 药物 青少年 重度抑郁发作 

分 类 号：R749.41[医药卫生—神经病学与精神病学]