度洛西汀联合重复经颅磁刺激治疗抑郁症临床研究  

Clinical Study of Duloxetine Combined with Repetitive Transcranial Magnetic Stimulation in the Treatment of Depression

作　　者：何雪梅 梁子红 杨帆 阿拉腾巴根 郝利霞 高艺芳 罗嘉欣 白志坚 HE Xuemei;LIANG Zihong;YANG Fan;ALA Tengbagen;HAO Lixia;GAO Yifang;LUO Jiaxin;BAI Zhijian(Inner Mongolia Autonomous Region People′s Hospital,Hohhot,Inner Mongolia,China 010010;Inner Mongolia Autonomous Region Mental Health Center,Hohhot,Inner Mongolia,China 010050)

机构地区：[1]内蒙古自治区人民医院,内蒙古呼和浩特010010 [2]内蒙古自治区精神卫生中心,内蒙古呼和浩特010050

出　　处：《中国药业》2025年第1期82-86,共5页China Pharmaceuticals

基　　金：内蒙古自治区自然科学基金[2023QN08060]。

摘　　要：目的探讨度洛西汀联合重复经颅磁刺激(rTMS)治疗抑郁症的临床疗效,以及对患者认知功能的影响。方法选取内蒙古自治区人民医院2020年1月至2022年9月收治的抑郁症患者94例,按随机数字表法分为观察组和对照组,各47例。两组患者均予度洛西汀肠溶胶囊,观察组患者联合rTMS治疗。两组患者均连续治疗6周。结果观察组的治疗总有效率为95.74%,显著高于对照组的82.98%(P<0.05)。治疗后1周、2周、4周、6周,观察组患者的汉密尔顿抑郁量表17版(HAMD-17)评分均显著低于对照组同期(P<0.05)。两组患者治疗后的重复性成套神经心理状态测验量表(RBANS)评分均显著升高(P<0.05),且观察组显著高于对照组(P<0.05);血清脑源性神经营养因子前体蛋白水平均显著降低(P<0.05),且观察组显著低于对照组(P<0.05);血清胰岛素样生长因子1、精氨酸加压素水平均显著升高(P<0.05),且观察组均显著高于对照组(P<0.05);血清多巴胺、5-羟色胺、去甲肾上腺素水平均均显著升高(P<0.05),且观察组均显著高于对照组(P<0.05)。观察组与对照组不良反应发生率相当(12.77%比8.51%,P>0.05)。结论度洛西汀联合rTMS治疗抑郁症的临床疗效良好,可改善患者的神经递质水平,提高认知功能,且安全性较高。Objective To investigate the clinical efficacy of duloxetine combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of depression,and its effect on patients′cognitive function.Methods A total of 94 patients with depression admitted to the Inner Mongolia Autonomous Region People′s Hospital from January 2020 to September 2022 were selected and divided into the observation group and the control group by the random number table method,with 47 cases in each group.The patients in the two groups were treated with Duloxetine Enteric-Coated Capsules,on this basis,the patients in the observation group were treated with rTMS.Both groups were continuously treated for six weeks.Results The total effective rate in the observation group was 95.74%,which was significantly higher than 82.98%in the control group(P<0.05).After 1 week,2 weeks,4 weeks,and 6 weeks of treatment,the Hamilton Depression Rating Scale 17-items version(HAMD-17)scores in the observation group were significantly lower than those in the control group during the same period(P<0.05).After treatment,the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)score in the two groups significantly increased(P<0.05),and that in the observation group was significantly higher than that in the control group(P<0.05);the level of serum brain-derived neurotrophic factor precursor protein(pro-BDNF)in the two groups significantly decreased(P<0.05),and that in the observation group was significantly lower than that in the control group(P<0.05);the levels of serum insulin-like growth factor 1(IGF-1)and arginine vasopressin(AVP)significantly increased(P<0.05),and those in the observation group in the two groups were significantly higher than those in the control group(P<0.05);the levels of serum dopamine,serotonin,and norepinephrine significantly increased(P<0.05),and those in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was comp

关 键 词：度洛西汀 重复经颅磁刺激 抑郁症 认知功能 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R971.43[医药卫生—药学] R2-031