iTBS模式重复经颅磁刺激联合氟伏沙明治疗首发青少年抑郁症非自杀性自伤行为的临床观察  

A Clinical observation of TBS mode rTMS combined with Fluvoxamine on the treatment of first-episodeadolescent depression with non-suicidal self-injury behaviors

作　　者：林红 刘陈 尹娥 肖志刚 廖卉 LIN Hong;LIU Chen;YIN E(Yichang Special Care Hospital,Yichang Psychiatric Disease Clinical Medical Research Center,Yichang 443005,China)

机构地区：[1]宜昌市优抚医院,宜昌市精神心理疾病临床医学研究中心,宜昌443005 [2]宜昌三峡中心人民医院

出　　处：《国际精神病学杂志》2023年第4期716-718,共3页Journal Of International Psychiatry

基　　金：2021年宜昌市医疗卫生研究项目(编号:A21-2-061)。

摘　　要：目的 探讨间歇性θ脉冲刺激(iTBS)模式重复经颅磁刺激(rTMS)治疗首发青少年抑郁症中非自杀性自伤(NSSI)行为的疗效.方法 将首发伴NSSI行为的青少年抑郁症患者随机分为两组,对照组给予氟伏沙明治疗(n=36),研究组在其基础上联合iTBS模式rTMS治疗(n=38).采用汉密尔顿抑郁量表(HAMD)评定其病情,TESS量表记录其不良反应,Barratt冲动量表(BIS-Ⅱ)中文修订版评定其冲动行为,青少年NSSI行为功能评估量表评定其自伤水平.结果 治疗2周后,研究组HAMD评分较治疗前显著降低(P<0.05),第4周时两组患者均较治疗前显著降低(P<0.01),且组间存在显著差异(P<0.01).治疗4周后两组患者BIS-Ⅱ修订版评分和青少年NSSI行为功能评估量表(NSSI-AT)修订版评分较治疗前也均显著降低(P<0.01),且研究组显著低于对照组(P<0.05).结论 iTBS模式rTMS能显著降低伴有NSSI行为青少年抑郁症患者的抑郁情绪、冲动性及自伤水平,安全有效.Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in in-termittent theta burst stimulation(iTBS)mode in the treatment of non-suicidal self-injury(NSSI)behaviors in first-episode adolescents with depression.Methods Adolescent depression patients with first-episode NSSI behaviors were randomly divided into two groups,the control group was given fluvoxamine treatment(n=36),and the study group was given iTBS mode rTMS treatment on the basis of the control group(n=38).We used the Hamilton Depression Scale(HAMD)to assess their condition,the TESS scale to record their adverse reactions,the Barratt Impulsivity Scale(BIS-Ⅱ)Chinese revised version to assess their impulsive behavior,and the Adolescent NSSI Behavioral Function Assessment Scale to assess them level of self-harm.Results After 2 weeks of treatment,there was a significant dif-ference in the study group compared with before treatment(P<0.05).At the 4th week,the HAMD scores of the two groups of patients were significantly lower than those before treatment(P<0.01),and there was a significant dfference between the groups(P<0.01).After 4 weeks of treatment,the BIS-Ⅱ revised version score and the Adolescent NSSI-AT revised version scores in the two groups were significantly lower than those before treatment(P<0.01),And the score of the study group was significantly lower than that of the control group(P<0.05).Conclusion The iTBS mode rTMS can significantly reduce depression,impulsivity and self-injury levels in adolescent depression patients with NSSI behavior,which is safe and effective.

关 键 词：重复经颅磁刺激 青少年抑郁 非自杀性自伤 iTBS 

分 类 号：R749.94[医药卫生—神经病学与精神病学]