重复经颅磁刺激治疗难治性强迫症的随机对照研究  

A Randomized Controlled Trial of Repetitive Transcranial Magnetic Stimulation in the Treatment of Refractory Obsessive-compulsive Disorder

作　　者：周朝雄 熊涛 汤斌华 ZHOU Chaoxiong;XIONG Tao;TANG Binhua(Jiangxi Provincial Mental Hospital,Nanchang 330000,China)

机构地区：[1]江西省精神病院,江西南昌330000

出　　处：《中国医学创新》2022年第27期142-145,共4页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20204100)。

摘　　要：目的:分析重复经颅磁刺激(rTMS)治疗难治性强迫症的临床价值。方法:选择江西省精神病院2020年1月-2021年1月收治的难治性强迫症(ROCD)患者61例作为研究对象,根据就诊编号采用随机信封法将其分为观察组(31例)和对照组(30例)。对照组行常规治疗,观察组在常规治疗基础上加用rTMS治疗。根据治疗前后的Yale-Brown强迫量表(YBOCS)评分情况比较两组治疗效果,比较两组治疗前后的焦虑抑郁情况,比较两组治疗期间药物副反应情况。结果:观察组治疗总有效率为96.77%,高于对照组的66.67%(P<0.05)。治疗2、4、8周时,观察组的汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分均低于对照组,差异均有统计学意义(P<0.05)。治疗2、4、8周时,两组的治疗副反应量表(TESS)评分差异均无统计学意义(P>0.05)。结论:rTMS能提高ROCD患者的治疗效果,进一步调节患者情绪,不增加治疗风险。Objective:To analyze the clinical value of repetitive transcranial magnetic stimulation(rTMS)in the treatment of refractory obsessive-compulsive disorder(ROCD).Method:A total of 61 patients with refractory obsessive-compulsive disorder who were admitted to Jiangxi Provincial Mental Hospital from January 2020 to January 2021 were selected as the research objects,and they were divided into observation group(31 cases)and control group(30 cases)by random envelope method according to the number of visits.The control group received conventional treatment,the observation group was treated with rTMS on the basis of conventional treatment.The treatment effects of the two groups were compared according to the scores of Yale-Brown obsessive-compulsive scale(YBOCS)before and after treatment,the anxiety and depression of the two groups were compared before and after treatment,the side effects of drugs were compared between the two groups.Result:The total effective rate of the observation group was 96.77%,which was higher than 66.67%of the control group(P<0.05).At 2,4 and 8 weeks of treatment,the scores of Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 2,4,and 8 weeks of treatment,there were no significant differences in the scores of treatment emergent response scale(TESS)between the two groups(P>0.05).Conclusion:rTMS can improve the treatment effect of patients with ROCD,further regulate patients’emotions,and do not increase the risk of treatment.

关 键 词：重复经颅磁刺激 难治性强迫症 YALE-BROWN强迫量表 

分 类 号：R749.7[医药卫生—神经病学与精神病学]