重复经颅磁刺激联合认知行为疗法对帕金森病合并抑郁症的康复效果  

Rehabilitation efficacy of repetitive transcranial magnetic stimulation combined with cognitive behavioral therapy in Parkinson’s disease complicating depression

作　　者：李锦棉 张敏 成雄超 刘夏 申俊杰 李春梅 LI Jinmian;ZHANG Min;CHENG Xiongchao;LIU Xia;SHEN Junjie;LI Chunmei(Morita Patients Ward,Nanning Municipal Fifth People’s Hospital,Nanning,Guangxi 530001,China;Department of Gerontology,Nanning Municipal Social Welfare Hospital,Nanning,Guangxi 530003,China;Department of Integrated Chinese and Western Medicine,Nanning Municipal Fourth People’s Hospital/HIV/AIDS Clinical Treatment Center of Guangxi(Nanning),Nanning,Guangxi 530023,China;Medical College,Guangxi University,Nanning,Guangxi 530004,China)

机构地区：[1]南宁市第五人民医院/南宁心理医院森田病区,南宁530001 [2]南宁市社会福利医院老年医学科,南宁530003 [3]南宁市第四人民医院中西医结合科/广西艾滋病临床治疗中心(南宁),南宁530023 [4]广西大学医学院,南宁530004

出　　处：《重庆医学》2024年第23期3590-3595,3601,共7页Chongqing Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研项目(Z20211662,Z20201114)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)联合认知行为疗法(CBT)对帕金森病合并抑郁症(dPD)患者康复效果的影响。方法选取2020年2月至2023年2月南宁市第五人民医院的70例dPD患者为研究对象,根据随机数字表法分为观察组和对照组,每组35例,期间对照组脱落3例。对照组给予rTMS治疗,观察组给予rTMS联合CBT治疗,比较治疗前、治疗第4周、治疗第16周两组抑郁症状缓解情况,使用汉密尔顿抑郁量表(HAMD)、社会功能缺陷筛选量表(SDSS)、自动思维问卷(ATQ)评估抑郁症状程度、负性自动思维、社会功能的改善效果。结果两组HAMD、SDSS、ATQ评分的治疗方式、时间因素和时间与治疗方式的交互差异有统计学意义(P<0.05)。单因素方差分析结果显示,两组HAMD、SDSS、ATQ评分随治疗时间延长依次下降(P<0.05)。多变量方差分析结果显示,观察组治疗第4、16周HAMD、SDSS、ATQ评分低于对照组(P<0.05)。结论rTMS+CBT治疗dPD抗抑郁明显,改善负性思维及提高社会功能。Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with the cognitive behavioral therapy(CBT)on the rehabilitation efficacy of the patients with Parkinson’s disease complicating depression(dPD).Methods Seventy patients with dPD in the Nanning Municipal Fifth People’s Hospital from February 2020 to February 2023 were selected as the study subjects and divided into the observation group and control group according to the random number table method,35 cases in each group.Three cases in the control group during the study period came off.The control group was given the rTMS treatment,while the observation group was treated by rTMS+CBT.The remission situations of depressive symptoms before treatment,in 4,16 weeks after treatment were compared between the two groups.The Hamilton Depression Scale(HAMD),Social Disability Screening Schedule(SDSS)and Automatic Thinking Questionnaire(ATQ)were used to evaluate the improvement effect of depression degree,negative automatic thinking and social function.Results There were statistically significant differences in the treatment mode,time factor and the interaction between time and treatment mode in HAMD,SDSS and ATQ scores between the two groups(P<0.05).The one-way ANOVA results revealed that the HAMD,SDSS and ATQ scores in the two groups were in turn decreased with the treatment time extension(P<0.05).The multivariate ANOVA analysis results demonstrated that the HAMD,SDSS and ATQ scores in 4,16 weeks after treatment in the observation group were lower than those in the control group(P<0.05).Conclusion rTMS+CBT for treating dPD has significant anti-depression effect,improves the negative thinking and increases the social function.

关 键 词：帕金森病 抑郁症 重复经颅磁刺激 认知行为疗法 抗抑郁治疗 

分 类 号：R749.4[医药卫生—神经病学与精神病学]