目的 探讨抑郁症患者开展重复经颅磁刺激(rTMS)治疗的临床效果,及其对认知功能、血清甲状腺素及炎性细胞因子水平的影响.方法 于2020年3月～2023年3月采集病历资料入档,对象为医院收治的抑郁症患者,共计纳入100例,纳入对象基于"随机数字表法"1:1分组,划分为对照组(予以盐酸文拉法辛缓释片治疗)与观察组(对照组用药+rTMS治疗),各组均50例;观察对比两组抑郁程度、认知功能、血清甲状腺素及炎性细胞因子.结果 与对照组相比,观察组治疗2周、4周的17项-汉密尔顿抑郁量表(the 17 items Hamilton Depression Scale,HAMD-17)评分显著低(P＜0.05);治疗后,两组蒙特利尔认知功能评估量表(the Montreal Cognitive Function Assessment Scale,MoCA)评分、简易精神状态检查表(Mini-Mental State Examination,MMES)评分均升高,且观察组更高(P＜0.05);治疗后,两组肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-6(Interleukin-6,IL-6)、白介素-1β(Interleukin-1β,IL-1β)水平均下降,且观察组更低(P＜0.05);治疗后,两组三碘甲状腺原氨酸(Triiodothyronine,T3)、甲状腺激素(Thyroxine,T4)、促甲状腺素(Thyroid-stimulating hormone,TSH)均高于同组治疗前,且观察组高于对照组(P＜0.05).结论 抑郁症合并失眠患者实施rTMS治疗,可显著改善患者抑郁状态,同时可抑制炎症因子,调节血清甲状腺素,改善患者认知障碍.
The effect of repeated transcranial magnetic stimulation on cognitive function,serum thyroxine,and inflammatory cytokine levels in depression patients with insomnia
Objective To explore the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)in the treatment of depression patients.Methods The case data were collected and filed from March 2020 to March 2023.Totally 100 patients with depression were enrolled in the hospital.The participants were divided into control group(treated with venlafaxine hydrochloride sustained-release tablets)and observation group(control group,medication plan+rTMS treatment)based on the"random number table"1:1 grouping,with 50 patients in each group;Observe and compare the levels of depression,cognitive function,serum thyroxine,and inflammatory cytokines between the two groups.Results Compared with the control group,the observation group had significantly lower scores on the 17 items Ham-ilton Depression Scale(HAMD-17)after 2 and 4 weeks of treatment(P＜0.05).After treatment,the scores of the Montreal Cognitive Function Assessment Scale(MoCA)and Minimal Mental State Examination(MMES)increased in both groups,and the observation group had a higher score(P＜0.05).After treatment,the levels of TNF-α,IL-6 and IL-1β were decreased in both groups,and the observation group was even lower(P＜0.05).After treatment,the lev-els of triiodothyronine(T3),thyroxine(T4)and thyroid stimulating hormone(TSH)in both groups were higher than those before treatment in the same group,and higher than those in the control group(P＜0.05).Conclusion The rTMS treatment can significantly improve the depressive state of patients with depression and insomnia,inhibit inflam-matory factors,regulate serum thyroxine,and play a positive role in improving cognitive impairment.
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