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《低頻重復(fù)經(jīng)顱磁刺激治療首發(fā)抑郁癥的臨床對(duì)照研究.pdf》由會(huì)員上傳分享,免費(fèi)在線(xiàn)閱讀,更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、四川I精神衛(wèi)生2014年第27卷第3期http://www.psychim.net.a(chǎn)n低頻重復(fù)經(jīng)顱磁刺激治療首發(fā)抑郁癥的臨床對(duì)照研究馬元業(yè)王軍王潤(rùn)澤【摘要】目的探討低頻重復(fù)經(jīng)顱磁刺激(rTMS)治療首發(fā)抑郁癥的療效及安全性。方法采用隨機(jī)數(shù)字表法將符合《中國(guó)精神障礙分類(lèi)與診斷標(biāo)準(zhǔn)(第3版)》(CCMD一3)的65例首發(fā)抑郁癥患者分為rTMS組33例和氟西汀組32例,觀(guān)察期6周。用漢密爾頓抑郁量表(HAMD一17)、漢密爾頓焦慮量表(HAMA)及副反應(yīng)量表(TESS)分別評(píng)定療效及不良反應(yīng)。結(jié)果rTM
2、S組有效率78.8%,氟西汀組有效率84.4%,兩組療效相當(dāng)(P>0.05);在第1周末rTMS組HAMD一17和HAMA評(píng)分較氟西汀組低,差異有統(tǒng)計(jì)學(xué)意義(P<均0.05);rTMS組和氟西汀組不良反應(yīng)發(fā)生率分別為12.1%和40.6%,差異有統(tǒng)計(jì)學(xué)意義(P<0.01)。結(jié)論rTMS治療首發(fā)抑郁癥的效果與氟西汀相當(dāng),但起效較氟西汀快、不良反應(yīng)發(fā)生率低于氟西汀?!娟P(guān)鍵詞】重復(fù)經(jīng)顱磁刺激;氟西??;首發(fā)抑郁癥中圖分類(lèi)號(hào):R749文獻(xiàn)標(biāo)識(shí)碼:Adoi:10.3969/j.issn.1007—3256.20
3、14.03.025AcontrolledclinicalctudyofrTMSintreatmentoffirst——episodedepressionMAYuan—ye,WANGJun,WANGRun—zeTheThirdHospitalofTianshui,Tianshui741000,China【Abstract】0bjectiveToexploretheeficacyandsafetyofslowrepetitivetranscranialmagnetivestimulation(rTMS)
4、forpa—tientswithfirst—episodedepression.Methods65patientswithfirst—episodedepressionwererandomlydividedintorTMSgroup(33casestreatedwithrTMS)andfluoxetinegroup(32casestreatedwithfluoxetine)for6weeks.TheeficacywasassessedwithHAMDl7andHAMA.whiletheadverse
5、reactionswereassessedwithTESS.ResultsTheeffectiverateofrTMSgroupis78.8%.Theeffectiverateoffluoxetinegroupis84.4%.Thereisnodifferencebetweenthetwogroupsineficacy(P>0.05).WhilethescoresoftheHAMDl7andHAMAinrTMSgroupsignificantlydecreasedthanthoseinfluoxet
6、inegroupattheendofthefirstweek(P<0.05).Theincidenceofadversereactionis12.1%inrTMSgroup.whiletheincidenceofadversereactionis40.6%influoxetinegroup.Thereareobviousdifferencebetweenthetwogroupsonadversereactions(P<0.01).ConclusionrTMStakeseffectfasterthan
7、fluoxetine,theincidenceofadversereactionislessthanfluoxetine,anditisaseffectiveasfluoxetineintreatmentoffirst—episodedepression.【Keywords】rTMS;Fluoxetine;First—episodedepression抑郁癥是一種常見(jiàn)的心境障礙,以顯著而持久頻TMS對(duì)抑郁癥的治療效果尚無(wú)定論J。為驗(yàn)的心境低落為主要臨床特征,從悶悶不樂(lè)到悲痛欲證rTMS治療首發(fā)抑郁癥
8、的效果及安全性,本研究絕,嚴(yán)重者可出現(xiàn)自殺¨?,F(xiàn)代醫(yī)學(xué)研究認(rèn)為抑郁選取首次發(fā)作抑郁癥患者為研究對(duì)象,以氟西汀治癥與中樞神經(jīng)遞質(zhì)代謝異常有關(guān),尤其與突觸間隙療為對(duì)照組,對(duì)rTMS治療首發(fā)抑郁癥的效果及安5羥色胺(5一HydroxyTryptamine,5一HT)和去甲腎全性進(jìn)行臨床對(duì)照研究,以期為首發(fā)抑郁癥患者的上腺素(Norepinephrine,NE)濃度的變化有著密切的臨床治療提供參考。關(guān)系。氟西汀為選擇性血清素再吸收抑制劑(Se—lectiveSerotonin