重复经颅磁刺激联合药物治疗老年抑郁症患者的临床疗效  

Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Drugs in the Treatment of Senile Depression

作　　者：孙妍 林冬梅[2] SUN Yan;LIN Dong-Mei(Department of Psychology,Yingkou Fourth People's Hospital,Yingkou 115001,China;Psychological sleep adjustment center,Jilin neuropsychiatric hospital,Siping 136000,China)

机构地区：[1]营口市第四人民医院心理科,辽宁营口115001 [2]吉林省神经精神病医院心理睡眠调适中心,吉林四平136000

出　　处：《中国药物经济学》2022年第7期73-75,79,共4页China Journal of Pharmaceutical Economics

基　　金：吉林省卫生健康适宜技术推广项目(20195018)。

摘　　要：目的 探讨重复经颅磁刺激(rTMS)联合药物治疗老年抑郁症患者的临床疗效。方法 选取2019年3月至2020年3月营口市第四人民医院收治的老年抑郁症患者104例作为研究对象,根据治疗方案不同分为药物组和联合组,每组52例。药物组患者单纯予以阿戈美拉汀口服治疗,联合组患者则在药物组基础上联合r TMS治疗。运用汉密尔顿抑郁量表(HAMD)和简易智能精神状态检查量表(MMSE)评定患者抑郁情绪和认知功能的变化,采集患者治疗前后空腹静脉血测定血清神经元特异性烯醇化酶(NSE)和髓鞘碱性蛋白(MBP)水平,并观察两组不良反应情况。结果 两组治疗前HAMD、MMSE评分比较,差异无统计学意义(P>0.05);治疗后,两组HAMD、MMSE评分均低于治疗前,且联合组HAMD、MMSE评分均低于药物组,差异有统计学意义(P<0.05)。两组治疗前血清NSE、MBP水平比较,差异无统计学意义(P>0.05);治疗后,两组血清NSE、MBP水平均有所下降,且联合组血清NSE、MBP水平均低于药物组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 r TMS联合抗抑郁药物治疗老年抑郁症,有助于修复神经元损伤,提升临床疗效,更好地改善患者抑郁症状和认知功能,且安全性尚可。Objective To evaluate the clinical effect of repeated transcranial magnetic stimulation(rTMS) combined with drugs in the treatment of senile depression.Methods 104 elderly patients with depression admitted to the Fourth People’s Hospital of Yingkou City from March 2019 to March 2020 were selected as the research objects.They were divided into drug group and combined group according to different treatment schemes,with 52 cases in each group.Patients in the drug group were treated with Agomelatin orally.Patients in the combined group were treated with rTMS on the basis of the drug group.The changes of depression mood and cognitive function were evaluated by Hamilton Depression scale(HAMD) and simple Mental State examination scale(MMSE) in both groups.Fasting venous blood before and after treatmentwere collected to determine the levels of neuronal specific enolase(NSE) and myelin basic protein(MBP) in serum.Adverse reactions were observed in both groups.Results There was no significant difference in HAMD and MMSE scores between the two groups before treatment(P>0.05).The scores of HAMD and MMSE in the two groups were lower than those before treatment(P0.05).The serum NSE and MBP of the two groups decreased significantly(P<0.05).The serum NSE and MBP in the combined group were lower than those in the drug group(P<0.05).Compared with the adverse reactions of the two groups,there was no significant difference(P<0.05).Conclusion RTMS combined with antidepressants in the treatment of senile depression is helpful to repair neuronal injury,improve clinical efficacy,improve depressive symptoms and cognitive impairment,and the safety is good.

关 键 词：重复经颅磁刺激 抗抑郁药 联合治疗 老年抑郁症 疗效 

分 类 号：R749.7[医药卫生—神经病学与精神病学] R971[医药卫生—临床医学]