重复经颅磁刺激联合温阳解郁方治疗围绝经期抑郁的效果及对患者相关指标和不良反应的影响  

Effect of repeated transcranial magnetic stimulation combined with Wenyang Jieyu Recipe on perimenopausal depression and its influence on related indicators and adverse reactions of patients

作　　者：靳西龙[1] 宋宝华[2] 刘建君[3] 宋刚[4] 黄光彪 JIN Xi-Long;SONG Bao-Hua;LIU Jian-Jun(Department of Medical Science,the Third People's Hospital of Huzhou,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市第三人民医院医务科,浙江湖州313000 [2]湖州市第三人民医院物理治疗中心,浙江湖州313000 [3]湖州市第三人民医院情感障碍科,浙江湖州313000 [4]湖州市第三人民医院检验科,浙江湖州313000 [5]湖州市第三人民医院开放精神科,浙江湖州313000

出　　处：《中国妇幼保健》2022年第18期3297-3301,共5页Maternal and Child Health Care of China

基　　金：浙江省湖州市科技局公益性研究项目(2020GYB51)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合温阳解郁方治疗围绝经期抑郁的效果及对患者相关临床指标和不良反应的影响。方法选取2020年2月—2021年11月湖州市第三人民医院收治的120例围绝经期抑郁患者为研究对象,随机分为对照组和观察组,每组各60例,对照组患者采取rTMS治疗,观察组患者在对照组基础上加用温阳解郁方治疗,比较两组患者治疗效果、睡眠质量、不良反应、神经递质水平、性激素水平、炎症细胞因子水平及生活质量的差异。结果观察组患者治疗总有效率(96.67%)高于对照组(81.67%),差异有统计学意义(χ^(2)=6.988,P<0.05)。两组患者不良反应总发生率(观察组为6.67%,对照组为3.33%)比较,差异无统计学意义(χ^(2)=0.175,P>0.05)。治疗后,观察组患者各睡眠质量评分均高于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组患者脑源性神经营养因子(BDNF)、去甲肾上腺素(NE)及雌二醇(E_(2))水平[(43.29±3.17)pg/ml、(11.26±2.03)μg/ml及(70.26±3.64)pg/ml]均高于对照组[(35.29±3.54)pg/ml、(8.63±1.35)μg/ml及(59.58±2.84)pg/ml],差异均有统计学意义(t=13.041、8.356及17.919,均P<0.05)。治疗后,观察组患者肿瘤坏死因子(TNF-α)、白介素-6(IL-6)及IL-1β水平[(11.63±0.96)ng/ml、(10.36±0.86)ng/ml及(8.26±0.95)ng/ml]均高于对照组[(17.36±1.35)ng/ml、(16.25±1.04)ng/ml及(11.36±1.27)ng/ml],差异均有统计学意义(t=26.794、33.807及15.140,均P<0.05)。治疗后,观察组患者各生活质量评分均高于对照组,差异均有统计学意义(均P<0.05)。结论围绝经期抑郁患者采取rTMS联合温阳解郁方治疗,可显著改善患者临床症状,提高患者生活质量和睡眠质量。Objective To explore the effect of repeated transcranial magnetic stimulation(rTMS)combined with Wenyang Jieyu Recipe in the treatment of perimenopausal depression and its influence on relevant clinical indicators and adverse reactions.Methods A total of 120 perimenopausal depression patients admitted to the Third People's Hospital of Huzhou from February 2020 to November 2021 were randomly divided into control group and observation group,with 60 patients in each group.The patients in the control group were treated with rTMS,and the patients in the observation group were treated with Wenyang Jieyu Recipe on the basis of the control group.The treatment effect,sleep quality,adverse reaction,neurotransmitter,sex hormone level,inflammatory cytokine level and quality of life were compared between the two groups.Results The total effective rate of the observation group(96.67%)was higher than that of the control group(81.67%),and the difference was statistically significant(χ^(2)=6.988,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(6.67%in the observation group and 3.33%in the control group)(χ^(2)=0.175,P>0.05).After treatment,the sleep quality scores of the patients in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,the levels of brain-derived neurotrophic factor(BDNF),norepinephrine(NE)and estradiol(E_(2))in the observation group[(43.29±3.17)pg/ml,(11.26±2.03)μg/ml and(70.26±3.64)pg/ml]were significantly higher than those in the control group[(35.29±3.54)pg/ml,(8.63±1.35)μg/ml and(59.58±2.84)pg/ml](t=13.041,8.356 and 17.919,all P<0.05).After treatment,tumor necrosis factor(TNF-α),the levels of interleukin-6(IL-6)and IL-1β[(11.63±0.96)ng/ml,(10.36±0.86)ng/ml and(8.26±0.95)ng/ml]were significantly higher than those of the control group[(17.36±1.35)ng/ml,(16.25±1.04)ng/ml and(11.36±1.27)ng/ml](t=26.794,33.807 and 15.140,all P<0.05).After treatment,the

关 键 词：重复经颅磁刺激 温阳解郁方 围绝经期抑郁 不良反应 

分 类 号：R749.42[医药卫生—神经病学与精神病学]