首页|重复经颅磁刺激联合米氮平治疗抑郁症伴睡眠障碍患者的疗效及对认知功能的影响

重复经颅磁刺激联合米氮平治疗抑郁症伴睡眠障碍患者的疗效及对认知功能的影响

Effect of repetitive transcranial magnetic stimulation combined with mirtazapine on cognitive function in depressive patients with sleep disorders

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目的 探讨重复经颅磁刺激(Repetitive Transcranial Magnetic Stimulation,rTMS)联合米氮平治疗对抑郁症伴睡眠障碍患者的效果以及对认知功能的改善作用.方法 将80例抑郁症伴睡眠障碍的患者随机分为两组.对照组仅给予米氮平治疗.观察组在对照组基础上给予10Hz rTMS治疗.采用汉密尔顿抑郁量表-17(Hamilton's Depression Scale-17,HAMD-17)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分、蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)在治疗前后对抑郁症状、睡眠情况和认知功能进行评估.并用治疗时出现的症状量表(Treatment Emergent Symptom Scale,TESS)评估其不良反应的发生率.结果 治疗4周后,两组患者的症状均得到明显缓解.观察组HAMD-17评分、PSQI评分均显著低于对照组(P<0.05).观察组MoCA总评分及各个维度评分均高于对照组(P<0.05),差异均有统计学意义.对照组不良反应发生率高于观察组,但差异无统计学意义(P>0.05).结论 总的来说,rTMS联合米氮平治疗抑郁症伴失眠障碍患者在抑郁症状、缓解睡眠和认知功能改善均取得有益的效果.
Objective To investigate whether Repetitive Transcranial Magnetic Stimulation(rTMS)combined with mirtazapine not only has a beneficial effect on symptoms in patients with depression and sleep disorders,but also improves cognitive function.Methods 80 patients with depression and sleep disorder were randomly divided into two groups.The control group was treated with mirtazapine only.Observation group was given 10Hz rTMS on the basis of control group.Depressive symptoms,sleep status and cognitive function were assessed before and after treatment us-ing Hamilton Depression Scale-17,Pittsburgh Sleep Quality Index score and Montreal Cognitive Assessment Scale.The incidence of adverse reactions was assessed by the Treatment Emergent Symptom Scale.Results After 4 weeks of treatment,the symptoms of both groups were significantly relieved.HAMD17 scores and PSQI scores in observation group were significantly lower than those in control group(P<0.05).The total MoCA score and all dimension scores of the observation group were significantly higher than those of the control group(P<0.05),and the differences were sta-tistically significant.The incidence of adverse reactions in control group was higher than that in observation group,but the difference was not statistically significant(P>0.05).Conclusion Overall,these results suggest that rTMS com-bined with mirtazapine has a beneficial effect on depressive symptoms,relief of sleep,and improvement of cognitive function in patients with depression and sleep disorders.

DepressionSleep disordersCognitive functionRepeated transcranial magnetic stimulationMir-tazapine

王佳苗、葛茂宏、高雅昆、康瑞雪、胥爱萍

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潍坊医学院临床医学院/潍坊医学院(潍坊,261000)

潍坊市精神卫生中心

抑郁症 睡眠障碍 认知功能 重复经颅磁刺激 米氮平

山东省医药卫生科技发展计划项目

202112070931

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)