重复经颅磁刺激联合阿戈美拉汀、舍曲林治疗抑郁症伴失眠的效果及对神经递质、炎性因子水平的影响  

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Agomelatine and Sertraline in the Treatment of Depression with Insomnia and the Effects on the Levels of Neurotransmitters and Inflammatory Fac⁃tors

作　　者：刘琦 赖晓勤[2] LIU Qi;LAI Xiaoqin(Department of Psychology,Xianyue Hospital of Xiamen Medical College(Xiamen Xianyue Hospital,Fujian Provincial Psychiatry Center,Fujian Provincial Clinical Medical Research Center for Mental Diseases),Xiamen,Fujian Province,361000 China;Department of Emergency Medicine,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian Province,361000 China)

机构地区：[1]厦门医学院附属仙岳医院(厦门市仙岳医院,福建省精神医学中心,福建省精神疾病临床医学研究中心)心理科,福建厦门361000 [2]厦门大学附属中山医院急诊内科,福建厦门361000

出　　处：《中外医疗》2024年第13期26-30,共5页China & Foreign Medical Treatment

摘　　要：目的分析将重复经颅磁刺激联合阿戈美拉汀、舍曲林用于抑郁症伴失眠治疗中的效果。方法方便选取2021年4月—2023年4月厦门医学院附属仙岳医院收治的88例抑郁症伴失眠患者为研究对象,以随机数表法分为对照组、观察组,各44例,对照组给予阿戈美拉汀联合舍曲林治疗,观察组给予阿戈美拉汀联合舍曲林治疗+重复经颅磁刺激,比较两组疗效及神经递质[γ-氨基丁酸(γ-aminobutyric Acid,GABA)、5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(Dopamine,DA)],炎性因子[血清C反应蛋白(C-reactive Protein,CRP)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-10(Interleukin-10,IL-10)]水平、抑郁症状与睡眠质量评分。结果治疗后与对照组比较,观察组总有效率、GABA、5-HT、IL-10水平更高,DA、CRP、IL-1β水平更低,差异有统计学意义(P均<0.05);治疗后与对照组比较,观察组匹兹堡睡眠质量指数、汉密尔顿抑郁量表评分更低,差异有统计学意义(t=8.400、8.376,P均<0.05)。结论相较于单纯使用阿戈美拉汀联合舍曲林的药物治疗,在其基础上增加重复经颅磁刺激治疗抑郁症伴失眠患者对提升临床疗效效果更为显著,不仅可有效调节神经递质与炎性因子水平,还能改善抑郁与失眠程度。Objective To analyze the effect of repetitive transcranial magnetic stimulation combined with agomelatine and sertraline in the treatment of depression with insomnia.Methods 88 patients with depression with insomnia admitted to Xianyue Hospital of Xiamen Medical College from April 2021 to April 2023 were conveniently selected as the research object,and were grouped by random number table method,with 44 cases in the control group and 44 cases in the observation group.The control group was given agomelatine combined with sertraline treatment,and the observation group was given agomelatine combined with sertraline treatment+repeated transcranial magnetic stimulation.The efficacy and neurotransmitters[γ-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT),dopamine(DA)],inflammatory factors[serum C-reactive protein(CRP),interleukin-1β(IL-1β),interleukin-10(IL-10)]levels,scores of depressive symptoms and sleep quality were compared between the two groups.Results Compared with the control group after treatment,the observation group had higher total effective rate,GABA,5-HT,and IL-10 levels,and lower DA,CRP,and IL-1βlevels,the differences were statistically significant(all P<0.05).Compared with the control group after treatment,Pittsburgh Sleep Quality Index and Hamilton Depression Scale scores were lower in the observation group,the differences were statistically significant(t=8.400,8.376,both P<0.05).Conclusion Compared with the simple use of agomelatine combined with sertraline drug therapy,the addition of repetitive transcranial magnetic stimulation on its basis for the treatment of patients with depression with insomnia is more significant in enhancing the clinical efficacy of the effect,not only can effectively regulate the level of neurotransmitters and inflammatory factors,but also improve the degree of depression and insomnia.

关 键 词：阿戈美拉汀 舍曲林 重复经颅磁刺激 抑郁症伴失眠 神经递质 炎性因子 

分 类 号：R749[医药卫生—神经病学与精神病学]