重复经颅磁刺激联合氟西汀治疗老年抑郁症的临床对照研究.docxVIP

重复经颅磁刺激联合氟西汀治疗老年抑郁症的临床对照研 究 茅卫兵 江飞 朱圣洁 徐健 (南通市第四人民医院 江苏南通226005) 【摘要】R的：探讨rTMS治疗老年抑郁症首次发病患者的有效性及安全性。 方法：采用随机、单肓对照法，将63例年龄大于60岁的抑郁症首发患者分为 rTMS组和氟西汀组，两组均服用氟西汀20mg/d, rTMS组加用6周rTMS真性刺 激，以10Hz. 90%运动阈值刺激患者左前额叶背外侧，氟西汀组加用6周rTMS 伪刺激治疗。治疗前后用汉密顿抑郁量表(HAMD?17)和副反应量表(TESS)评价疗效 和不良反应。结果：实际完成观察63例，其屮rTMS组31例，氟西汀组32例。 治疗第1周末，rTMS组的HAMD总分较治疗前明显下降(P0.01),有效率及 减分率均高于氟西汀组(P0.05)o氟西汀组HAMD总分在治疗第2周末较治 疗前明显下降(P0.01)；治疗第1,2周末，rTMS组有效率高于氟西汀组，组间 差异均有统计学意义(P O.05)o治疗第4,6周末，rTMS组治愈率高于氟西汀组， 组间差异均有统计学意义(P0.05),而两组有效率的差异无统计学意义 (Pgt;O.05)o两组患者出现药物不良反应者各4例，差异无统计学意义 (Pgt;O.05)o结论:rTMS联合氟西汀治疗老年首发抑郁症患者起效较快、安全、 疗效肯定,治愈率更高。 【关键词】抑郁症；老年人；氟西汀；重复经颅磁刺激 【屮图分类号】R453 【文献标识码】A 【文章编号】1007-8231 (2016) 09-0037-03 The efficacy and tolerabilityl of repetitive transeranial magnetic stimulation(rTMS) combined with fluoxetine in treatment of elderly patients with first-episode depression Mao Weibing,Jiang Fei,Zhu Shengjie,Xu Jian. The Forth Hospital of Nantong,Nantong 226005‘China 【Abstract] Objective To study the efficacy and safety of repetitive transeranial magnetic stimulation(rTMS) combined with fluoxetine in treating the elderly patients with first-episode depression.Methods A ran dom,single blind study was con ducted in 63 first-episode depressive patients aged 60 years or over.The patients were assigned to fluoxeti ne treatme nt(20mg/d) in combi nation with a six-week period of either rTMS(rTMS group)or sham procedure(fluoxetine group) on left dorsolateral prefront cortex(10Hz,90% motor threshold).The efficacy was evaluated with the humilton rating scale for depression(HAMD). The safety profiles were assessed with TESS.Results 63 cases were finished the study.At the end of weeks 1 ,sign讦icantly more HAMD score reduction was in rTMS group than in fluoxetine group.At weeks 1 and 2,the response rates in rTMS group were significantly higher than fluoxetine group(P 0.01).At weeks 4 and 6,the remission rates in rTMS group were significantly higher than fluoxetine group(P 0.01),the response rates were not sign ifi