高频重复经颅磁刺激联合舍曲林对非自杀性自伤青少年抑郁症患者抑郁症状和自伤行为的影响  

Effect of high-frequency repetitive transcranial magnetic stimulation combined with sertraline on depressive symptoms and self-injurious behaviors in adolescents with depression and nonsuicidal self-injury

作　　者：徐鹏昊 王艳 毛丽彦 Xu Penghao;Wang Yan;Mao Liyan(Department of Psychiatry,The Third Hospital of Quzhou,Quzhou 324000,Zhejiang Province,China)

机构地区：[1]衢州市第三医院精神科,衢州324000

出　　处：《中国基层医药》2024年第8期1149-1153,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省衢州市科技攻关项目(2023K189)。

摘　　要：目的:探讨高频重复经颅磁刺激联合舍曲林对非自杀性自伤青少年抑郁症患者抑郁症状和自伤行为的影响。方法:本研究为前瞻性研究,收集2021年1月至2023年9月衢州市第三医院治疗的非自杀性自伤青少年抑郁症患者112例,并按照随机数字表法分为对照组和研究组各56例,分别接受舍曲林治疗和高频重复经颅磁刺激联合舍曲林治疗。观察干预前后两组青少年抑郁症患者抑郁状态评分[采用汉密尔顿抑郁量表-24(HAMD-24)和抑郁自评量表(SDS)进行评估]、自伤情况、炎症指标[肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)、白细胞介素β(IL-1β)]水平。结果:干预前两组HAMD-24评分和SDS评分差异均无统计学意义(均P>0.05),干预后两组HAMD-24评分和SDS评分均降低(均P<0.05),且研究组患者HAMD-24评分[(13.46±3.98)分]和SDS评分[(50.28±5.13)分]均显著低于对照组[(19.89±4.23)分、(71.62±6.88)分],差异均有统计学意义(t=-8.28、-18.61,均P<0.05)。干预前两组自伤次数和自伤行为评分差异均无统计学意义(均P>0.05),干预后研究组患者的自伤次数和自伤行为均显著改善(均P<0.05),对照组的自伤次数相较干预前有所改善(P<0.05),但自伤行为程度并没有得到改善(P>0.05),且干预后研究组患者自伤次数[(2.15±1.06)次]和自伤行为评分[(2.41±0.65)分]均显著低于对照组[(5.43±3.61)次、(12.04±3.01)分],差异均有统计学意义(t=-7.78、-23.40,均P<0.05)。干预前两组IL-1β水平和TNF-α水平及IL-10水平差异均无统计学意义(均P>0.05),干预后研究组患者IL-1β和TNF-α水平均显著低于干预前(均P<0.05),而IL-10水平显著高于干预前(P<0.05),对照组患者的IL-1β、TNF-α和IL-10在干预前后差异均无统计学意义(均P>0.05),且干预后研究组患者IL-1β水平[(57.15±6.33)ng/L]和TNF-α水平[(13.87±5.91)ng/L]均显著低于对照组[(73.61±8.52)ng/L、(17.12±5.28)ng/L],IL-10水平[(1.62±0.66)ng/L]显著高�Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimulation combined with sertraline on depressive symptoms and self-injurious behaviors in adolescents with depression and non-suicidal self-injury.Methods This study was a prospective study.A total of 112 adolescent patients with depression and non-suicidal self-injury who received treatment at the Third Hospital of Quzhou from January 2021 to September 2023 were included in this study.These patients were divided into a control group and a study group,with 56 patients per group,using the random digital table method.The control group was treated with sertraline,while the study group was treated with high-frequency repetitive transcranial magnetic stimulation combined with sertraline.The depression scores[assessed using the 24-item Hamilton Depression Scale(HAMD-24)and the Self-Rating Depression Scale(SDS)],self-injury status,and inflammatory factor levels(tumor necrosis factor-α,interleukin-10,and interleukin-1βlevels)were compared before and after the intervention.Results Before intervention,there were no statistically significant differences in HAMD-24 scores and SDS scores between the two groups(both P>0.05).After intervention,both HAMD-24 scores and SDS scores decreased significantly in both groups(both P<0.05).Additionally,the HAMD-24 scores[(13.46±3.98)points]and SDS scores[(50.28±5.13)points]in the study group were significantly lower than those in the control group[(19.89±4.23)points,(71.62±6.88)points,t=-8.28,-18.61,both P<0.05].Before intervention,there were no statistically significant differences in the number of self-injury incidents and self-injurious behavior scores between the two groups(both P>0.05).After intervention,the number of self-injury incidents and the score of self-injurious behaviors significantly decreased in the study group compared with before intervention(both P<0.05).After intervention,the number of self-injury incidents in the control group was decreased compared with before intervention

关 键 词：抑郁症 经颅磁刺激 舍曲林 自我伤害行为 青少年 

分 类 号：R749.4[医药卫生—神经病学与精神病学]