经颅磁刺激联合无抽搐电休克及常规抗抑郁药治疗中重度抑郁症的临床疗效分析  

Clinical Efficacy Analysis of Transcranial Magnetic Stimulation Combined with Electroconvulsive Therapy and Conventional Antidepressants in the Treatment of Moderate to Severe Depression

作　　者：叶晓斌 杨陈翔 郑锦元 罗倩 朱嘉欣 王颖 YE Xiaobin;YANG Chenxiang;ZHENG Jinyuan;LUO Qian;ZHU Jiaxin;WANG Ying(Zhangzhou The Forth Hospital,Zhangzhou 350003,China)

机构地区：[1]漳州市第四医院,福建漳州363000

出　　处：《中华灾害救援医学》2024年第8期889-892,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探索经颅磁刺激(Transcranial Magnetic Stimulation,TMS)联合无抽搐电休克(Modified Electroconvulsive Therapy,MECT)及常规抗抑郁药治疗中重度抑郁症的疗效。方法选取2023年3月至2024年2月在漳州市第四医院就诊的54例中重度抑郁症患者,根据抽签法随机分为两组,观察组采用TMS+MECT+药物治疗,对照组采用MECT+药物治疗,每组各27例。对比两组患者不同时间点焦虑及抑郁情况、临床疗效及不良反应情况。结果治疗前,两组患者汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分(P=0.467)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评分(P=0.418)均无显著差异(P>0.05)。治疗后2周、4周、8周,两组患者HAMD和HAMA评分均较治疗前减低(P<0.05),且治疗后2周、4周、8周观察组HAMD评分和HAMA评分均低于对照组(P<0.001)。治疗后,观察组患者临床有效率为96.30%,高于对照组患者的74.07%(P=0.022)。治疗期间,观察组患者中有5例(18.52%)出现不良反应,与对照组患者的4例(14.82%)相比,差异无统计学意义(P=0.715)。结论TMS联合MECT及常规抗抑郁药治疗可有效改善中重度抑郁症患者的焦虑及抑郁情况,临床疗效显著,且安全性较高。Objective To investigate the efficacy of transcranial magnetic stimulation(TMS)combined with modified electroconvulsive therapy(MECT)and conventional antidepressant treatment for moderate to severe depression.Methods 54 patients with moderate to severe depression who were treated at Zhangzhou Fourth Hospital from March 2023 to February 2024 were selected and randomly divided into two groups by lottery.The observation group(TMS+MECT+medication,27 cases)and the control group(MECT+medication,27 cases)were compared.Anxiety and depression levels,clinical efficacy,and adverse reactions were evaluated at different time points.Results Before treatment,there were no significant differences between the two groups in Hamilton Depression Rating Scale(HAMD)scores for anxiety(P=0.467)and Hamilton Anxiety Rating Scale(HAMA)scores for depression(P=0.418)(P>0.05).At 2,4,and 8 weeks after treatment,both HAMD and HAMA scores decreased compared to pre-treatment levels in both groups(P<0.05).At the same time points,the observation group had significantly lower HAMD and HAMA scores than those of the control group(P<0.001).After treatment,26 patients in the observation group showed effective outcomes(clinical efficacy rate of 96.30%),which was higher than that(20 patients)in the control group(clinical efficacy rate of 74.07%),with a statistical significance of(P=0.022).During the treatment period,5 patients(18.52%)in the observation group experienced adverse reactions,which was not significantly different from that 4 patients(14.82%)in the control group(P=0.715).Conclusion The combination of TMS,MECT,and conventional antidepressants can effectively improve anxiety and depression in patients with moderate to severe depression,demonstrating significant clinical efficacy and high safety.

关 键 词：经颅磁刺激 电休克 抗抑郁药 抑郁症 

分 类 号：R749[医药卫生—神经病学与精神病学]