重复经颅磁刺激联合草酸艾司西酞普兰对老年抑郁症认知缺损患者的疗效观察  

Effects of repeated transcranial magnetic stimulation combined with escitalopram oxalate on cognitive function and depressive symptoms in elderly patients with depression

作　　者：郭青山 杜琴 戴立磊 杜晖 GUO Qingshan;DU Qin;DAI Lilei(Jingmen Second People's Hospital,Jingmen 448000,China)

机构地区：[1]湖北省荆门市第二人民医院,荆门488000

出　　处：《国际精神病学杂志》2023年第1期78-81,共4页Journal Of International Psychiatry

基　　金：2017-2018年度湖北省卫生计生委指导性项目(编号:WJ2017F094);荆门市科学技术研究与开发计划项目(编号:2018YDKY007)。

摘　　要：目的观察重复经颅磁刺激(repetitive Transcranial Magnetic Stimulation,rTMS)对老年抑郁症认知功能缺损患者治疗前后抑郁症状及认知功能的变化。方法将92例老年抑郁症认知功能缺损患者通过计算机产生随机数分为两组,观察组rTMS联合草酸艾司西酞普兰治疗46例,对照组草酸艾司西酞普兰治疗46例,分别在治疗前、治疗后4周应用蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)评估认知功能,汉密尔顿抑郁量表(Hamilton’s Depression Scale,HAMD)评估抑郁症状。并根据HAMD减分率来评估疗效,分析rTMS治疗与认知功能之间的相关性。结果观察组和对照组治疗总有效率分别为93.47%及89.13%,观察组显著高于对照组,差异有统计学意义(P<0.05)。观察组与对照组治疗前HAMD及MoCA评分对比差异无统计学意义(P>0.05),治疗后HAMD评分观察组显著低于对照组,差异有统计学意义(P<0.05),MoCA评分观察组显著高于对照组,差异有统计学意义(P<0.05)。结论rTMS联合药物治疗老年抑郁症认知功能缺损患者,可以比单用药物更好地改善认知功能及抑郁症状。Objective This study aimed to compare the difference in the severity of depression and cognitive function among elderly depressed patients with and without the treatment of repeated transcranial magnetic stimulation(rTMS).Methods 92 elderly patients with cognitive impairment of depression were divided into two groups by random number generated by computer.46 patients in the observation group were treated with rTMS combined with escitalopram oxalate,and 46 patients in the control group were treated with escitalopram oxalate.Cognitive function and depressive symptoms were assessed using Montreal Cognitive Assessment Scale(MoCA)and Hamilton's DepressionScale(HAMD)at the before and 4-weeks after treatment,respectively.The efficacy of the treatment was assessed by HAMD subtraction rate.The correlation between rTMS treatment and cognitive function was estimated.Results The total effective rate of the observation group and the control group was 93.47%and 89.13%,respectively.The effective rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in HAMD and MoCA scores between the observation group and the control group before treatment(P>0.05),but HAMD score in the observation group was significantly lower than that in the control group after treatment(P<0.05).MoCA score in the observation group was significantly higher than that in the control group(P<0.05).Conclusion rTMS combined with medication can improve cognitive function and depressive symptoms in elderly patients with cognitive impairment of depression better than medication alone.

关 键 词：老年抑郁症 认知功能缺损 汉密尔顿抑郁量表 蒙特利尔认知评估量表 

分 类 号：R749.05[医药卫生—神经病学与精神病学]