高频重复经颅磁刺激在抑郁症急性期患者治疗中的增效作用  

Synergistic effect of high-frequency repetitive transcranial magnetic stimulation in the treatment of patients with acute depression

作　　者：班春霞[1] 孟美玲 倪章春 于伟霞 王湖 陈翔春[1] 汪崇泽[2] BAN Chunxia;MENG Meiling;NI Zhangchun;YU Weixia;WANG Hu;CHEN Xiangchun;WANG Chongze(Department of Psychiatry,Mental Health Center of Jiading District in Shanghai,Shanghai 201806,China;The Six Clinical Departments,Shanghai Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市嘉定区精神卫生中心精神科,上海201806 [2]上海交通大学医学院附属精神卫生中心临床六科,上海200030

出　　处：《新乡医学院学报》2022年第11期1055-1059,共5页Journal of Xinxiang Medical University

基　　金：上海市嘉定区农业和社会事业科研项目(编号:JDKW-2019-W06);上海市精神卫生中心院级课题(编号:2020-YJ15)。

摘　　要：目的探讨高频重复经颅磁刺激(rTMS)在抑郁症急性期治疗中的增效作用。方法选择2020年1月至2021年9月上海市嘉定区精神卫生中心和上海交通大学医学院附属精神卫生中心收治的94例抑郁症急性期患者为研究对象,根据治疗方法将患者分为对照组(n=48)和观察组(n=46)。观察组患者给予帕罗西汀联合rTMS治疗,对照组患者单用帕罗西汀治疗。分别于治疗前及治疗1、2、3周末,采用汉密尔顿抑郁量表(HAMD-24)评分评估2组患者抑郁症状。分别于治疗前和治疗3周末,采用临床总体印象量表-疾病严重度(CGI-S)量表评估2组患者病情严重程度。比较2组患者的临床疗效和治疗期间不良反应发生情况。结果2组患者的HAMD-24评分随治疗时间延长显著降低(F=206.83、308.98,P<0.001)。治疗前,观察组与对照组患者的HAMD-24评分比较差异无统计学意义(P>0.05);治疗1、2、3周末,观察组患者的HAMD-24评分均显著低于对照组(P<0.05)。2组患者治疗3周末CGI-S评分显著低于治疗前(P<0.05);治疗前,对照组与观察组患者的CGI-S评分比较差异无统计学意义(P>0.05);治疗3周末,观察组患者的CGI-S评分显著低于对照组(P<0.01)。治疗1周末,观察组患者治疗好转率高于对照组(χ^(2)=4.876,P<0.05);治疗2、3周末,观察组患者治疗有效率均高于对照组(χ^(2)=7.153、5.041,P<0.05);治疗3周末,观察组患者治疗临床痊愈率高于对照组(χ^(2)=4.055,P<0.05)。对照组与观察组患者的不良反应发生率分别为16.7%(8/48)、19.6%(9/46);对照组与观察组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.133,P>0.05)。结论高频rTMS联合帕罗西汀治疗抑郁症急性期起效快,高频rTMS对抑郁症急性期治疗具有一定的增效作用,且安全性较高。Objective To investigate the synergistic effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of patients with acute depression.Methods A total of 94 patients with acute depression admitted to Mental Health Center of Jiading District of Shanghai and Shanghai Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to September 2021 were selected as the research objects,and the patients were divided into the control group(n=48)and observation group(n=46)according to the treatment method.The patients in the observation group were treated with paroxetine combined with rTMS,while the patients in the control group were treated with paroxetine alone.The depressive symptoms of patients in the two groups was evaluated by Hamilton depression scale(HAMD-24)score before treatment and at the end of 1,2,3 weeks of treatment.Before treatment and at the end of 3 weeks of treatment,the severity of illness of patients in the two groups was evaluated by the clinical global impression-severity(CGI-S)scale.The clinical efficacy and adverse reactions during treatment were compared between the two groups.Results The HAMD-24 scores of patients in the two groups were significantly decreased with the extension of treatment time(F=206.83,308.98;P<0.001).Before treat ment,there was no significant difference in HAMD-24 score of patients between the observation group and the control group(P>0.05).At the end of 1,2 and 3 weeks of treatment,the HAMD-24 score of patients in the observation group was significantly lower than that in the control group(P<0.05).Before treatment,there was no significant difference in CGI-S score of patients between the control group and the observation group(P>0.05).The CGI-S score of patients at the end of 3 weeks of treatment was significantly lower than that before treatment in the two groups(P<0.05).At the end of 3 weeks of treatment,the CGI-S score of patients in the observation group was significantly lower than that in the con

关 键 词：抑郁症 重复经颅磁刺激 帕罗西汀 

分 类 号：R749.4[医药卫生—神经病学与精神病学]