重复经颅磁刺激联合艾司西酞普兰治疗青少年首发抑郁症的临床疗效及影响

doi:10.3969/j.issn.1000-8535.2022.06.014

广州医药 ›› 2022, Vol. 53 ›› Issue (6): 65-69.DOI: 10.3969/j.issn.1000-8535.2022.06.014

重复经颅磁刺激联合艾司西酞普兰治疗青少年首发抑郁症的临床疗效及影响

阮燕山, 卢圳耿, 叶秀儿, 蔡仲威, 唐瑞强, 梁光辉

东莞市第七人民医院精神心理科(东莞 523220)

收稿日期:2021-12-06 出版日期:2022-11-20 发布日期:2022-11-30
基金资助:
东莞市社会科技发展(一般)项目 (202050715006018)

Clinical efficacy and influence of repetitive transcranial magnetic stimulation combined with escitalopram in first-episode depression in adolescents

RUAN Yanshan, LU Zhengeng, YE Xiuer, CAI Zhongwei, TANG Ruiqiang, LIANG Guanghui

Department of Psychiatry,Dongguan Seventh People's Hospital,Dongguan 523220,China

Received:2021-12-06 Online:2022-11-20 Published:2022-11-30

摘要/Abstract

摘要： 目的探究青少年首发抑郁症患者治疗中联合应用艾司西酞普兰与重复经颅磁刺激(rTMS)的总疗效及应用价值。方法选取东莞市第七人民医院2020年5月—2021年10月80例青少年首发抑郁症患者,参考“数字双盲法”,分为对照组和观察组(各40例)2组,对照组接受伪rTMS+艾司西酞普兰治疗,观察组接受rTMS+艾司西酞普兰治疗。评价指标:临床总疗效、抑郁评分(17项汉密尔顿抑郁量表,HAMD-17)、认知功能评分(威斯康星卡片分类测验,WCST)、生活质量(SF-36评分),不良反应发生率(副反应量表,TESS)。结果观察组患者总有效率95.00%较对照组80.00%明显高(P＜0.05);且2组不良反应率比较(P＞0.05)。观察组治疗1周、2周、4周HAMD-17评分均较对照组低,同时治疗4周后WCST项目中完成分类评分较对照组更高(P＜0.05)。观察组SF-36(角色、社会、躯体、认知)评分均较对照组高(P＜0.05)。结论青少年首发抑郁症患者,在艾司西酞普兰用药基础上联合rTMS,可获取更为显著的治疗效果,控制病情进展,减轻抑郁症状,同时对认知功能无影响,促进生活质量大幅度提高,且用药安全性有保障。

关键词: 青少年, 首发抑郁症, 重复经颅磁刺激, 艾司西酞普兰

Abstract: Objective To explore the total efficacy and application value of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of adolescent patients with first-episode depression.Methods A total of 80 adolescent patients with first-episode depression in Dongguan Seventh People's Hospital from May 2020 to October 2021 were selected.Referring to the “digital double-blind method”,they were divided into control group and observation group (40 cases each).The control group was treated with pseudo rTMS and escitalopram,and the observation group was treated with rTMS and escitalopram.Evaluation indexes: total clinical efficacy,depression score (17-item Hamilton Depression Scale,HAMD-17),cognitive function score (Wisconsin Card Sorting Test,WCST),quality of life (SF-36 score),adverse reaction rate (Treatment Emergent Symptom Scale,TESS).Results The total effective rate of 95.00% in the observation group was significantly higher than 80.00% in the control group (P<0.05); the incidence of adverse reactions was compared between the two groups (P>0.05).The HAMD-17 scores of the observation group at 1 week,2 weeks and 4 weeks were significantly lower than those of the control group.At the same time,the classification scores of WCST items after 4 weeks of treatment were higher in observation group (P<0.05).The SF-36 (role,society,body and cognition) scores in the observation group were higher than those in the control group (P<0.05).Conclusions Adolescent patients with first-episode depression treated with rTMS on the basis of escitalopram can obtain more significant therapeutic effect,control the progress of the disease,reduce depressive symptoms,have no effect on cognitive function,greatly improve the quality of life,and ensure the safety of medication.

Key words: adolescent, first-episode depression, repetitive transcranial magnetic stimulation, escitalopram

阮燕山, 卢圳耿, 叶秀儿, 蔡仲威, 唐瑞强, 梁光辉. 重复经颅磁刺激联合艾司西酞普兰治疗青少年首发抑郁症的临床疗效及影响[J]. 广州医药, 2022, 53(6): 65-69.

RUAN Yanshan, LU Zhengeng, YE Xiuer, CAI Zhongwei, TANG Ruiqiang, LIANG Guanghui. Clinical efficacy and influence of repetitive transcranial magnetic stimulation combined with escitalopram in first-episode depression in adolescents[J]. Guangzhou Medical Journal, 2022, 53(6): 65-69.

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重复经颅磁刺激联合艾司西酞普兰治疗青少年首发抑郁症的临床疗效及影响

Clinical efficacy and influence of repetitive transcranial magnetic stimulation combined with escitalopram in first-episode depression in adolescents

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