基于神经生物机制探讨θ短阵快速脉冲重复经颅磁刺激模式治疗抑郁症效果  

Effectiveness of the θ short array fast pulse repetitive transcranial magnetic stimulation model for the treatment of depression based on neurobiological mechanisms

作　　者：邓江南 叶鑫武 赵飞飞 DENG Jiang-nan;YE Xin-wu;ZHAO Fei-fei(Wenzhou Seventh People's Hospital,Wenzhou 325000,China)

机构地区：[1]温州市第七人民医院精神科,325000 [2]温州市第七人民医院老年精神科,325000 [3]温州市第七人民医院儿童精神科,325000

出　　处：《临床精神医学杂志》2024年第5期364-368,共5页Journal of Clinical Psychiatry

基　　金：温州市科学技术科研项目(Y20211137)。

摘　　要：目的:探讨θ短阵快速脉冲重复经颅磁刺激(repetitive transcranial magnetic stimulation-theta burst stimulation,rTMS-TBS)模式治疗抑郁症效果。方法:选取92例抑郁症患者,随机数字表法分为TBS组31例、常规模式组31例、伪刺激组30例,均给予常规药物治疗,并分别予以rTMS-TBS模式刺激、rTMS常规模式刺激、伪刺激干预。统计并比较3组治疗效果、不良反应及治疗前后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、神经递质功率[多巴胺(dopamine,DA)、γ氨基丁酸(gamma aminobutyric acid,GABA)]和自主神经功能[交感神经皮肤反应(sympathetic skin response,SSR)波幅及潜伏期]。结果:TBS组治疗总有效率87.10%>常规模式组61.29%>伪刺激组40.00%(P<0.05);治疗第2周、第4周,TBS组SSR潜伏期、HAMD、HAMA<常规模式组<伪刺激组,DA、GABA、SSR波幅>常规模式组>伪刺激组(P<0.05);3组不良反应对比,差异无统计学意义(P>0.05)。结论:rTMS-TBS模式刺激治疗抑郁症患者效果优于常规模式,可有效改善患者焦虑、抑郁症状,缓解睡眠障碍,还能改善自主神经功能,且安全性高。Objective:To explore the therapeutic effect of repetitive transcranial magnetic stimulation-theta burst stimulation(rTMS-TBS)mode on depression.Method:Ninety-two patients with depression were divided into the TBS group,the conventional mode group and the pseudo-stimulation group by random number table method,all were given conventional medication and rTMS-TBS mode stimulation,rTMS conventional mode stimulation and pseudo-stimulation intervention respectively.The treatment effects,adverse effects,Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),neurotransmitter power[dopamine(DA),gamma aminobutyric acid(GABA)],and vegetative function[sympathetic skin response(SSR)amplitude and latency]of the three groups were counted and compared before and after treatment.Results:The total effective rate of treatment was 87.10% in the TBS group,which was higer than 61.29% in the conventional mode group and 40.00% in the pseudo-stimulation group(P<0.05);at week 2 and 4 of treatment,SSR latency,HAMD and HAMA in the TBS group<conventional mode group<pseudo-stimulation group,DA,GABA and SSR wave amplitude>conventional mode group>pseudo-stimulation group(P<0.05);the difference was not statistically significant when comparing the adverse effects of the three groups(P>0.05).Conclusion:The effect of rTMS-TBS stimulation in the treatment of depression patients is better than that of conventional mode,which can effectively improve the symptoms of anxiety and depression,relieve sleep disorders,improve the autonomic nerve function,and has high safety.

关 键 词：重复经颅磁刺激 抑郁症 θ短阵快速脉冲 神经 睡眠 

分 类 号：R749.4[医药卫生—神经病学与精神病学]