重复经颅磁刺激联合艾司西酞普兰在难治性抑郁症患者中的应用效果  

Effects of Repeat Transcranial Magnetic Stimulation Combined with Escitalopram in Patients with Treatment-Resistant Depression

作　　者：冯连启 刘杰 王娟 FENG Lianqi;LIU Jie;WANG Juan(Department of Psychiatry,Shangqiu Second People’s Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市第二人民医院精神科,河南商丘476000

出　　处：《河南医学研究》2025年第3期452-455,共4页Henan Medical Research

摘　　要：目的 探究重复经颅磁刺激(rTMS)联合艾司西酞普兰在难治性抑郁症患者中的应用效果。方法 选取商丘市第二人民医院2019年9月至2022年9月收治的192例难治性抑郁症患者进行研究。以随机数字表法分为两组,各96例。对照组接受艾司西酞普兰治疗。观察组接受rTMS联合艾司西酞普兰治疗。观察认知功能损伤、睡眠质量、抑郁评分、神经损伤相关因子、神经递质水平以及治疗的安全性。结果 干预前两组患者认知损害差异无统计学意义(P>0.05);干预后两组认知损害评分均升高,且观察组评分高于对照组(P<0.05)。干预前两组睡眠质量差异无统计学意义(P>0.05);干预后,两组睡眠质量评分均降低,观察组睡眠质量评分低于对照组(P<0.05)。干预前,两组患者的脑源性神经营养因子(BDNF)、去甲肾上腺素、5-羟色胺、神经元特异性烯醇化酶(NSE)、S-100B蛋白水平差异无统计学意义(P>0.05);干预后,两组BDNF、去甲肾上腺素、5-羟色胺水平均升高,NSE、S-100B蛋白均降低,且观察组BDNF、去甲肾上腺素、5-羟色胺水平高于对照组,观察组NSE、S-100B蛋白水平低于对照组(P<0.05)。干预前,两组患者的抑郁评分差异无统计学意义(P>0.05);干预后,两组抑郁评分均降低,观察组的抑郁评分低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论 rTMS联合艾司西酞普兰能够改善难治性抑郁症患者的认知损害、睡眠质量及抑郁程度,通过调节神经递质及神经细胞损伤因子水平减轻神经损伤抑制疾病进展,应用于临床安全有效。Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)combined with escitalopram in patients with treatment-resistant depression.Methods From September 2019 to September 2022,192 patients with refractory depression were admitted to Shangqiu Second People’s Hospital.They were divided into two groups with 96 cases each by random number table method.Escitalopram therapy was used as a control group.rTMS combination with escitalopram therapy was used in observation group.There was evidence of cognitive impairment,sleep quality,depression,nerve injury-related variables,neurotransmitter levels,and therapy safety were observed.Results There was no difference in cognitive impairment between the two groups before intervention(P>0.05).The cognitive impairment scores of the two groups were increased after intervention,and the scores of observation group were higher than those of control group(P<0.05).Before intervention,there was no difference in sleep quality between the two groups(P>0.05).After intervention,the sleep quality scores of both groups decreased,and the sleep quality scores of observation group were lower than that of control group(P<0.05).There was no difference in the contents of brain derived neurotrophic factor(BDNF),norepinephrine,5-hydroxytryptamine,neuron-specific enolase(NSE)and S-100B protein between the two groups before intervention(P>0.05).After intervention,the contents of BDNF,norepinephrine and 5-hydroxytryptamine in both groups increased,while NSE and S-100B protein decreased.The contents of BDNF,norepinephrine and 5-hydroxytryptamine in observation group were higher than those in control group,while the contents of NSE and S-100B protein in observation group were lower than those in control group(P<0.05).There was no difference in the depression score of the two groups before intervention(P>0.05).The depression score of the two groups was decreased after intervention,and the depression score of observation group was lower than that of control group(P<0.05).T

关 键 词：难治性抑郁症 重复经颅磁刺激 艾司西酞普兰 神经损伤 认知功能 睡眠 

分 类 号：R749[医药卫生—神经病学与精神病学]