低频重复经颅磁刺激治疗首发抑郁症患者的临床疗效观察.PDFVIP

低频重复经颅磁刺激治疗首发抑郁症患者的临床疗效观察 马元业 李 刚 周东林 马素杰 【摘要】目的 观察低频(2Hz)重复经颅磁刺激(rTMS)治疗首发抑郁症患者的临床疗 效和安全性。方法 对符合 DSM-Ⅳ分类与诊断标准的 63 例首次发作抑郁障碍患者，按随 机数字表分为 rTMS 组（n=32）和氟西汀组（n=31），治疗 6 周。采用汉密尔顿抑郁量表 (HAMD)和治疗时出现的症状量表（TESS）评定疗效及不良反应。结果 经 6 周治疗， rTMS 组和氟西汀组有效率差异无统计学意义(81.2％vs. 87.0％,P＞0.05)；在治疗第 1 周 末 rTMS 组和氟西汀组 HAMD 评分差异有统计学意义[(18.4±2.3）vs.( 19.8±2.4),P＜ 0.05]；两组不良事件发生率差异有统计学意义(12.5％vs.41.9％,P＜0.01)，其中 rTMS 组 常见头痛（9.4％）、头晕（3.1％），氟西汀组恶心（12.9％）、头晕（9.6％）、疲乏 （6.4％）、失眠（9.6％）、口干（3.2％）。结论 低频(2Hz)rTMS 治疗首发抑郁症起效 快，疗效与氟西汀相当，不良反应发生率低于氟西汀。 【关键词】低频重复经颅磁刺激；氟西汀；首发抑郁症；对照研究 Clinical observation on efficacy of low-frequency repetitive transcranial magnetic sti- mstimulation in the treatment of patients with first-episode depression. MA Yuanye, LI Gang, ZHOU Donglin,et al. Tianshui Mental Hospital, Gansu 741000, China. Corresponding auther:MA Yuan-Ye,ywmnh1234@163.com 【Abstract 】 Objective To observe the clinical efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of patients with first-episode depression.Methods 63 patients with first-episode depression were randomly divided into rTMS group(32 cases treated with rTMS) and fluoxetine group (31cases treated with fluoxetine)for 6 weeks.The efficacy was assessed with Hamilton Depression Scale(HAMD),the safety was assessed with Treatment Emergent Symptom Scale(TESS).Results The effective rate was 81.2 ％ in rTMS group and 87.0 ％in fluoxetine group after 6 weeks(P ＞0.05).There was no significance difference between the two groups on efficacy.But the score of the HAMD in rTMS group was lower than that in fluoxetine group at the end of the first week [(18.4±2.3)vs.(19.8±2.4),P ＜ 0.05].The rate of side effects was 12.5% in rTMS group and 41.9% in fluoxetine group.There was signi