中国临床心理学杂志

青年难治性抑郁症患者重复经颅磁刺激治疗研究

单位：1. 中南大学湘雅二医院精神卫生研究所湖南长沙 410011
2. 湖南省脑科医院精神科湖南长沙 410007
3. 深圳市南山区慢性病防治院

分类号：R395.2

出版年,卷(期):页码：2010,18(1):44-46

摘要：

目的：探讨高频重复经颅磁刺激(rTMS)对单相难治性抑郁症的治疗价值和安全性。方法：36例青年难治性抑郁症患者随机分为真刺激组及药物治疗组，共接受20次rTMS治疗。治疗开始及疗程结束时使用汉密尔顿抑郁量表(HAMD)、贝克抑郁自评量表(BDI)、大体功能评定量表(GAF)及匹茨堡睡眠质量指数量表(PSQI)评定疗效。结果：治疗结束后，磁刺激组有效12例，其中痊愈4例，有效率为63.2%。药物组有效2例，有效率11.8%。卡方值为14，P=0.000。rTMS组治疗后，患者HAMD评分从治疗前(24.68±3.01)分降低到(13.53±5.19)，药物组HAMD评分治疗前(24.47±2.62)，治疗后(20.88±4.30)。两组治疗后HAMD评分有显著性差异(P＜0.01)。治疗后，rTMS组的BDI、GAF及PSQI评分也明显低于单纯药物组，两组症状改善状况差异明显(P＜0.05)。结论：重复经颅磁刺激合并抗抑郁药物治疗难治性抑郁症安全有效。

Objective:To explore the applicability and safety of high frequency rTMS on unipolar intractable depression. Methods:36 young patients with Treatment-resistant depression were randomized to two groups of real TMS treatment group and sham rTMS treatment group, both with routine anti-depression drug treatment. Twenty times of high frequency rTMS were applied to the patients in rTMS group, while patients in drug group received only sham rTMS. Scores of HAMD, BDI, GAF and PSQI were assessed before and after the treatment in both groups. Results:The treatment efficiency in the rTMS group is 63.2% . It was efficacious in 12 patients, and 4 patients were remitted. The treatment efficiency in drug group is 11.8%. It was efficacious in 2 patients. Treatment efficiency in rTMS group was significantly better than that in pure drug group (P=0.000, Chi-square value=14). The depression scales also changed significantly after treatment in both groups (P<0.001):HAMD (mean ±SD)changed from 24.68 ±3.01 to 13.53 ±5.19 in rTMS group and HAMD (mean ±SD) changed from 24.47 ±2.62 to 20.88 ±4.30 in drug group. Additionally, scores of BDI, GAF and PSQI in rTMS group were significantly lower than that in drug group (P<0.001). Conclusion:rTMS together with drug provide an effective and well-tolerant treatment for intractable depression.

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作者简介：

参考文献：

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