重复经颅磁刺激合并度洛西汀治疗抑郁症临床研究.docVIP

重复经颅磁刺激合并度洛西汀治疗抑郁症临床研究 　　【摘 要】 目的 对重复经颅磁刺激（rTMS）合并度洛西汀治疗抑郁症进行探讨，研究其临床疗效及副作用。方法 将84例抑郁症患者随机分为观察组和对照组，每组各42例，研究组给予rTMS真刺激，对照组给予rTMS假刺激，对右侧前额叶进行刺激（都给予5赫兹，连续4.9秒的刺激；每两次间隔30s，每次治疗给予10次刺激，10次一个疗程，持续28天）。合并给予度洛西汀，于治疗前及治疗28天后后应用汉密尔顿抑郁量表（HAMD）及不良反应量表（TESS）对比两组的疗效不良反应。结果观察组治疗后的HAMD评分下降明显，与假刺激组相比存在统计学差异（P0.05），不良反应轻微。结论 重复经颅磁刺激（rTMS）合并度洛西汀治疗抑郁症效果好，无副反应。 　　【关键词】 重复经颅磁刺激；抗抑郁药；度洛西汀；抑郁症 　　Clinical Study on rTMS and duloxetine in the Treatment of Treatment-Resistant Depression 　　Yumei，Shi， Xioamei，Xu，Hongjie，Sun ，et al. （ChinaRongjun Hospital of He Bei Province，Baoding 071200，China） 　　Abstract：Objective To explore the efficacy and safety of repetitive transcranial magnetic stimulation（rTMS）combining with duloxetine in the treatment of depression. Methods Thirty patients with TRD were randomly divided into a real rTMS group and a sham rTMS group，both with Mirtazapine treatment.Each patient in the real rTMS group received 20 rTMS sessions over 4 weeks to the left dorsolateral prefrontal cortex.Hamilton Depression Scale（HAMD）and treatment emergent symptom scale（ TESS） were used to assess the therapeutic effect of two treatment methods at baseline and at 4 weeks after treatment.Adverse reactions were observed and recorded in a 4 weeks’duration.Results There was significant improvement in the real rTMS group，as measured by scores on the HAMD and TESS.The difference between the real rTMS group and the sham rTMS group was significant（P0.05）.There was no serious adverse reaction.Conclusions As an effective and safe treatment for treatment-resistant depression，repetitive transcranial magnetic stimulation（rTMS）combining with Mirtazapine has broad application prospects. 　　Key words：Repetitive transcranial magnetic stimulation（rTMS） ；Antidepressant； Mirtazapine； Depression 　　抑郁是临床常见的一种精神障碍疾病，迄今为止，抑郁障碍的发病原因尚不明确，多数学者认为，与生物、心理、社会等多方面因素有关[1]。Barker等学者在1985年首先创立了经颅磁刺激（transcranial magnetic stimulation，TMS），这是一种新型神经电生理技术，目前已在临床研究及治疗中得到广泛应用[2]。TMS主要有3种主要刺激模式：重复性TMS（rTMS）、单脉冲TMS（sTMS）及双脉冲TMS（p