摘要
目的探讨重复经颅磁刺激(r TMS)联合米那普仑治疗难治性抑郁的疗效和安全性。方法随机选取2017年4月—2018年4月本院收治的62例难治性抑郁症患者,采用随机分配法分为实验组(n=31)和对照组(n=31)。两组在为期4周的治疗期间均给予米那普仑治疗。实验组联合r TMS治疗,对照组联合假刺激治疗。分别于治疗前、治疗后第2周末、第4周末使用汉密尔顿抑郁量表(HMAD-17)评定临床疗效,使用副反应量表(TESS)评定不良反应。结果治疗结束后,实验组显效率为64.5%,有效率为83.9%,对照组显效率为41.9%,有效率为67.7%。实验组显效率、有效率均显著高于对照组(均P<0.05);两组在HAMD-17量表评分比较,实验组在治疗第2周末、第4周末时减分率与对照组比较差异具有统计学意义(P<0.05);两组治疗过程中TESS分值变化对比差异没有统计学意义(均P>0.05)。结论与单纯使用米那普仑治疗比较,重复经颅磁刺激(r TMS)联合米那普仑治疗难治性抑郁患者,疗效肯定、安全,r TMS不会增加不良反应。
Objective To discuss the effects and safety of repetitive transcranial magnetic stimulation( rTMS) combined with milnacipran in the treatment of the refractory depression. Methods 62 patients with refractory depression admitted to the hospital from April 2017 to April 2018 selected,and they were randomly divided into control group( n = 31) and study group( n = 31). The control group was treated with milnacipran and sham r TMS,and the study group was treated with rTMS and milnacipran. The clinical efficacy of the two groups was evaluated by using HAMD-17 and TESS scale before treatment and at the 2nd,4th week after treatment.Results At the end of treatment,the significant effective rate of study group was 64.5%,and the effective rate was 83.9%. The significant effective rate of control group was 41. 9%,and the effective rate was 67. 7%. Thesignificant effective rate and effective rate of study group were significantly higher than those of the control group( P<0.05). The reduction of HAMD-17 score in study group was significantly different from that of the control group at the 2nd,4th week after the treatment( P< 0.05). There was no significant difference in the change of TESS scores between the two groups( P>0.05).Conclusions RTMS combined with milnacipran in the treatment of the refractory depression is effective and safe. What ’ s more,it doesn ’ t increase the occurrence of adverse effects.
作者
黄春晖
陈雪云
张婧
HUANG Chun-hui(The third hospital of Quanzhou,Quanzhou,Fujian,362000,China.)
出处
《齐齐哈尔医学院学报》
2018年第21期2512-2514,共3页
Journal of Qiqihar Medical University
关键词
重复经颅磁刺激
米那普仑
难治性抑郁症
Repetitive transcranial magnetic stimulation
Milnacipran
The refractory depression
