摘要
目的 探讨艾司西酞普兰联合高频重复经颅磁刺激(rTMS)对复发性抑郁障碍患者疗效、认知功能及生活质量的影响.方法 选取复发抑郁症患者66例,分为实验组(rTMS+艾司西酞普兰,n=33)和对照组(伪rTMS+艾司西酞普兰,n=33),疗程6周,以汉密尔顿抑郁量表(HA MD-17)、简明智能精神状态检查表(MMSE)、生活质量问卷(SF-36)评价疗效、认知功能及生活质量.结果 两组患者入组前HAMD-17得分比较,差异没有统计学意义(P＞0.05,t=0.049);治疗2、4、6周后得分均低于治疗前,且两组之间比较,差异有统计学意义(P＜0.05,F=27.75);随着时间推移患者的抑郁量表评分有明显差异(P＜0.05,F=1655.93),且实验组和对照组在不同时间点的变化趋势存在显著交互作用(P＜0.05,F=39.77).入院前两组MMSE评分比较,差异无统计学意义(P＞0.05,t=-0.983);治疗6周后,两组间MMSE评分比较,差异有统计学意义(P＜0.05).组内比较,实验组治疗前后MMSE评分比较,差异有统计学意义(P＜0.01,t=-5.458);对照组治疗前后MMSE评分比较,差异无统计学意义(P＞0.05,t=-1.940).实验组治疗前后SF-36各维度得分均明显提高,差异有统计学意义(P＜0.05),对照组生理职能、身体疼痛、总体健康、社会功能、情感职能、精神健康维度得分提高显著(P＜0.05或P＜0.01),生理功能、活力维度得分提升不显著(P＞0.05).结论 艾司西酞普兰联合高频重复经颅磁刺激较单用艾司西酞普兰可显著改善复发性抑郁障碍患者的抑郁状况、认知功能及生活质量.
Abstract
Objective To explore the effects of escitalopram combined with high-frequency repetitive tran-scranial magnetic stimulation(rTMS)on the efficacy,cognitive function,and quality of life in patients with recurrent de-pressive disorder.Methods A total of 66 patients with recurrent depression were selected,divided into an experimental group(rTMS+escitalopram,n=33)and a control group(sham rTMS+escitalopram,n=33).The treatment lasted for 6 weeks.The quality of life,cognitive function,and therapeutic effect were evaluated using the Quality of Life Questionnaire(SF-36),Mini-Mental State Examination(MMSE),and Hamilton Depression Rating Scale(HAMD-17).Results Before the study,there was no significant difference in HAMD-17 scores between the two groups(P＞0.05,t=0.049).After 2,4,and 6 weeks of treatment,the scores were lower than before the treatment,and there was a statistically significant difference between the two groups(P＜0.05,F=27.75).As time progressed,there was a noticeable difference in patients'depression scale scores(P＜0.05,F=1655.93),and there was a significant interaction in the changing trends between the experimental group and the control group at different points in time(P＜0.05,F=39.77).Before admission,there was no statistical significance in the MMSE scores comparison between the two groups(P＞0.05,t=-0.983).However,after 6 weeks of treatment,there was a statistically significant difference in the MMSE scores comparison between the two groups(P＜0.05).Within-group comparisons showed that there was a statistically significant difference in the MMSE scores before and after treatment in the experimental group(P＜0.01,t=-5.458),but no significant difference in the control group(P＞0.05,t=-1.940).The scores of all dimensions of SF-36 significantly increased before and after treat-ment in the experimental group,with statistical significance(P＜0.05).In the control group,significant improvements were observed in the scores for physical function,body pain,overall health,social function,emotional role,and mental health(P＜0.05 or P＜0.01),but not for vitality and physiological function(P＞0.05).Conclusion The combination of escitalopram and high-frequency repetitive transcranial magnetic stimulation significantly improves the depressive symp-toms,cognitive function,and quality of life of patients with recurrent depressive disorder compared to using escitalopram alone.
维普
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