重复经颅磁刺激联合帕罗西汀治疗产后抑郁症患者的效果及对性激素的影响  

Effect of repeated transcranial magnetic stimulation combined with paroxetine for postpartum depression patients and its impact on sex hormone

作　　者：许燕姗 何泉金 XU Yanshan;HE Quanjin(Obstetrics Department,73rd Group Army Hospital of People′s Liberation Army,Fujian Province,Xiamen 361001,China;不详)

机构地区：[1]中国人民解放军陆军第七十三集团军医院产科,福建省厦门市361001 [2]中国人民解放军陆军第七十三集团军医院神经内科,福建省厦门市361001

出　　处：《临床合理用药杂志》2024年第6期25-27,32,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察重复经颅磁刺激(rTMS)联合帕罗西汀治疗产后抑郁症患者的效果及对性激素的影响。方法选取2020年3月—2021年9月中国人民解放军陆军第七十三集团军医院收治的60例产后抑郁症患者作为研究对象,按照随机数字表法分为帕罗西汀组30例和联合rTMS组30例。帕罗西汀组采用帕罗西汀治疗,联合rTMS组在帕罗西汀组基础上联合rTMS治疗,2组均持续治疗6周。比较2组治疗前及治疗6周后实验室指标[去甲肾上腺素(NE)、超敏C反应蛋白(hs-CRP)、5-羟色胺(5-HT)、同型半胱氨酸(Hcy)、雌二醇(E_(2))、卵泡刺激素(FSH)、促甲状腺激素(TSH)、黄体生成素(LH)]、汉密尔顿抑郁量表(HAMD)评分、爱丁堡产后抑郁量表(EPDS)评分、匹兹堡睡眠质量指数(PSQI)评分及不良反应。结果治疗6周后,2组血清NE、5-HT、E_(2)、FSH、LH水平高于治疗前,血清hs-CRP、Hcy、TSH水平低于治疗前,且联合rTMS组升高/降低幅度大于帕罗西汀组(P<0.01);2组HAMD、EPDS、PSQI评分低于治疗前,且联合rTMS组低于帕罗西汀组(P<0.01)。联合rTMS组头晕、腹泻、恶心总发生率为13.33%,与帕罗西汀组的20.00%比较,差异无统计学意义(χ^(2)=0.480,P=0.488)。结论rTMS联合帕罗西汀治疗产后抑郁症患者可有效减轻炎症,调节神经递质及性激素水平,进而减轻产后抑郁状况,改善睡眠质量,且安全性较高。Objective To investigate the effect of rTMS combined with paroxetine for postpartum depression patients and its impact on sex hormone.Methods A total of 60 patients with postpartum depression were selected in 73rd Group Army Hospital of People′s Liberation Army from March 2020 to September 2021,and they were divided into the paroxetine group and the rTMS combination group according to random number table method,30 cases in each group.Patients in the paroxetine group were treated with paroxetine,and patients in the rTMS combination group were treated with rTMS on the basis of paroxetine group,both groups were treated for 6 weeks.Laboratory indexes(NE,hs-CRP,5-HT,Hcy,E_(2),FSH,TSH,LH),scores of HAMD,EPDS,PSQI before and after 6 weeks of treatment,incidence of adverse reactions were compared between the two groups.Results After 6 weeks of treatment,serum levels of NE,5-HT,E_(2),FSH,LH of the two groups were higher than those before treatment,serum levels of hs-CRP,Hcy,TSH were lower than those before treatment,and increase/decrease range of the indexes in the rTMS combination group were larger than those in the paroxetine group(P<0.01);Scores of HAMD,EPDS,PSQI in the two groups were lower than those before treatment,and the rTMS combination group were lower than those in the paroxetine group(P<0.01).Total incidence of dizziness,diarrhea,nausea of the rTMS combination group was 13.33%,there was no significant difference compared with 20.00%of the paroxetine group(χ^(2)=0.480,P=0.488).Conclusion rTMS combined with paroxetine can effectively improve inflammation in the treatment of postpartum depression,it can adjust the levels of neurotransmitters and sex hormone,and then reduce postpartum depression,improve sleep quality,and with higher safety.

关 键 词：产后抑郁症 重复经颅磁刺激 帕罗西汀 性激素 炎症 

分 类 号：R749.4[医药卫生—神经病学与精神病学]