首页|重复经颅磁刺激合并抗抑郁药对难治性抑郁障碍的疗效分析

重复经颅磁刺激合并抗抑郁药对难治性抑郁障碍的疗效分析

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目的 探讨重复经颅磁刺激(rTMS)合并抗抑郁药治疗难治性抑郁障碍(TRD)的疗效和安全性.方法 2021年12月~2023年8月在我院门诊和住院的100例难治性抑郁障碍患者,按照数字表法1:1比例随机分成研究组50例和对照组50例,研究组为10Hz左背外侧前额叶(DLPFC)重复经颅磁刺激(rTMS),对照组接受假性刺激,每个患者继续使用原治疗方案不变,共4~6周.在治疗前、治疗2周末、治疗4周末、治疗6周末应用汉密尔顿抑郁量表(Hamilton depression scale,HAMD-17)进行评分,在治疗前、治疗4周后应用CGI-S评定疾病严重情况.结果 研究组在治疗第2周末、第4周末、第6周末HAMD-17的减分率(%)分别是25.93、59.70、69.30,对照组在三个时点的HAMD-17减分率(%)分别是2.46、8.96、12.25,研究组明显高于对照组(P<0.01),具有统计学意义.在治疗6周末研究组和对照组缓解率分别为30.0%和0%,两组有效率分别为44.0%和2.0%,两组缓解率和有效率比较有显著性差异(P=0.000),具有统计学意义.在治疗4周末两组CGI-S评定,研究组降分明显高于对照组(P<0.01),具有统计学意义.结论 左侧背外侧前额叶高频经颅磁刺激合并抗抑郁药治疗难治性抑郁障碍起效早,疗效好,且安全性比较好.
Effectiveness of repetitive transcranial magnetic stimulation concomitant antidepressants use in patients with treatment-resistant depression
Objective The aim of this study was to prospectively evaluate the effectiveness and safety of high-fre-quency Repetitive transcranial magnetic stimulation(rTMS)over the left dorsolateral prefrontal cortex(DLPFC)con-comitant antidepressants use in patients with treatment-resistant depressive(TRD).Methods The authors conducted a 4 to 6 week double-blind,randomized,sham-controlled trial in 100 patients with treatment-resistant depression episode.100 TRD inpatients or outpatient in our hospital from December 2021 to August 2023 were randomly divided into 50 cases in study group and 50 control group according to the number table method.The study group received sys-tematic rTMS treatment High-frequency left-side dorsolateral prefrontal cortex repetitive transcranial magnetic stimula-tion(rTMS)and the control group received sham-stimulation,and the patients reveived concurrently antidepressants,for a total of 4-6 weeks.The primary outcome variable was the score on the 17-item Hamilton Depression Rating Scale(HAMD-17).Results There was no significant difference in HAMD-17 score between the two groups before treat-ment;The HAMD-17 score reduce rates(%)of the study group were 25.93、59.70、69.30 at weekend 2、4、6 re-spectively.There was a significant difference in the HAMD-17 score reduce rates between the two groups at weekend 2、4、6(F=101.341,P<0.01).A significant proportion of the study group met response rate(22 of 550[44.0%])or remission rate(15 of 50[30.0%])criteria by weekend 6 compared to the contral group(2 of 50[4.0%]and none of 50[0.00%]respectively).There were significant differences in response rate and remission rate between the two groups at weekend 6(P=0.000).Conclusion High-frequency repetitive transcranial magnetic stimulation(rTMS)over the left dorsolateral prefrontal cortex concomitant antidepressants use has substantial treatment efficacy and safety in patients with treatment-resistant major depression.

High-frequencyLeft dorsolateral prefrontal cortexRepetitive transcranial magnetic stimulationAntidepressantsTreatment-resistant depression

欧阳泽华、王瑞见、李海军、邓海涛、蒋云玉、张佳、王玉平、孙迷园、黄曦、曾令斌、戴建磊

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湖南省邵阳市脑科医院(邵阳,422000)

高频 左背外侧前额叶 重复经颅磁刺激 抗抑郁药 难治性抑郁障碍

湖南省邵阳市科技局市本级科技计划项目

2021GZ038

2024

国际精神病学杂志
中南大学

国际精神病学杂志

CSTPCD
影响因子:1.426
ISSN:1673-2952
年,卷(期):2024.51(4)