米氮平联合生物反馈脑电治疗抑郁症的研究
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摘要
目的探讨米氮平联合生物反馈脑电治疗抑郁症的临床疗效。方法选取112例抑郁症患者,分为观察组和对照组。对照组给予米氮平进行治疗,观察组在对照组基础上给予生物反馈脑电治疗,两组均治疗8周,两组治疗前后分别采用汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评定疗效,采用副反应量表(TESS)评定治疗副作用,并分别测定治疗前后血清去甲肾上腺素(NE)、5-羟色胺(5-HT)和多巴胺(DA)水平。结果观察组总有效率明显高于对照组(χ2=7.21,P<0.05)。两组治疗后2周、4周、8周HAMD评分均较治疗前明显降低(t分别=8.60、16.61、20.90、6.19、11.90、15.46,P均<0.05),且观察组治疗后2周、4周、8周HAMD评分均明显低于对照组(t分别=2.76、3.51、4.14,P均<0.05)。两组治疗后2周、4周、8周SDS评分均明显降低(t分别=7.32、17.70、28.97、4.18、9.59、16.67,P均<0.05),且观察组治疗后2周、4周、8周SDS评分均明显低于对照组(t分别=3.19、8.79、14.15,P均<0.05)。治疗后两组5-HT、NE及DA水平均明显升高(t分别=69.62、54.32、40.79、12.98、45.18、8.15,P均<0.05),但观察组升高较对照组更为明显(t分别=20.33、25.87、36.21,P均<0.05)。两组治疗后4周、8周TESS评分的差异均无统计学意义(t分别=1.15、0.85,P均>0.05)。两组不良反应发生率比较,差异无统计学意义(χ2=0.06,P<0.05)。结论米氮平联合生物反馈脑电治疗抑郁症效果好,安全性高,优于单用药物治疗。
Objective To investigate the clinical effect of mirtazapine combined with biological feedback electrical therapy on depression. Methods A total of 112 patients with depression were selected and randomly divided into the observation group and the control group with 56 cases in each. The control group was given mirtazapine treatment,while the observation group had EEG biofeedback treatment group on the basis of the control group treatment. The course was 8 weeks. The hamilton depression rating table(HAMD) and self rating depression scale(SDS),were used to assess the efficacy and the TESS for the adverse response. And serum norepinephrine(NE),5-hydroxy tryptamine(5-HT) and dopamine(DA) levels were measured before and after treatment. Results The total efficiency in the observation group was significantly higher than that in the control group(χ2=7.21,P <0.05). At 2 weeks,4 weeks and 8 weeks after treatment,the HAMD scores in the two groups were significantly lower than before treatment(t=8.60,16.61,20.90,6.19,11.90,15.46,P <0.05),which in the observation group were significantly lower than those in the control group(t=2.76,3.51,4.14,P<0.05). At 2weeks,4 weeks and 8 weeks after treatment,the SDS scores in the two groups were significantly lower than before treatment(t=7.32,17.70,28.97,4.18,9.59,16.67,P <0.05),which in the observation group were significantly lower than those in the control group(t=3.19,8.79,14.15,P<0.05). After treatment,the 5-HT,NE and DA levels in the two groups were significantly higher(t=69.62,54.32,40.79,12.98,45.18,8.15,P<0.05).But the observation group increased more significantly(t=20.33,25.87,36.21,P<0.05). The adverse reactions in the two groups was not statistically different(χ2=0.06,P <0.05). Conclusion The efficacy and safety of mirtazapine combined with biofeedback therapy to treat depression are better than single drug therapy.
Objective To investigate the clinical effect of mirtazapine combined with biological feedback electrical therapy on depression. Methods A total of 112 patients with depression were selected and randomly divided into the observation group and the control group with 56 cases in each. The control group was given mirtazapine treatment,while the observation group had EEG biofeedback treatment group on the basis of the control group treatment. The course was 8 weeks. The hamilton depression rating table(HAMD) and self rating depression scale(SDS),were used to assess the efficacy and the TESS for the adverse response. And serum norepinephrine(NE),5-hydroxy tryptamine(5-HT) and dopamine(DA) levels were measured before and after treatment. Results The total efficiency in the observation group was significantly higher than that in the control group(χ2=7.21,P <0.05). At 2 weeks,4 weeks and 8 weeks after treatment,the HAMD scores in the two groups were significantly lower than before treatment(t=8.60,16.61,20.90,6.19,11.90,15.46,P <0.05),which in the observation group were significantly lower than those in the control group(t=2.76,3.51,4.14,P<0.05). At 2weeks,4 weeks and 8 weeks after treatment,the SDS scores in the two groups were significantly lower than before treatment(t=7.32,17.70,28.97,4.18,9.59,16.67,P <0.05),which in the observation group were significantly lower than those in the control group(t=3.19,8.79,14.15,P<0.05). After treatment,the 5-HT,NE and DA levels in the two groups were significantly higher(t=69.62,54.32,40.79,12.98,45.18,8.15,P<0.05).But the observation group increased more significantly(t=20.33,25.87,36.21,P<0.05). The adverse reactions in the two groups was not statistically different(χ2=0.06,P <0.05). Conclusion The efficacy and safety of mirtazapine combined with biofeedback therapy to treat depression are better than single drug therapy.
引文
1郝伟.精神病学[M].第4版.北京:人民出版社,2008.128.
2 欧秋明,邓思灵.米氮平联合草酸艾司西酞普兰片治疗抑郁症的临床疗效及安全性评价[J].2015,31(13):1252-1253.
3 中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3)[M].济南:山东科技出版社,2001.83-90.
4 蒋雷,冯凌.米氮平联合小剂量氨磺必利治疗抑郁症的对照研究[J].中华全科医学,2014,12(5):721-722.
5 张加强,刘飞虎,张燕,等.抑郁症36例患者5-HT、NE、DA水平检测及临床意义[J].陕西医学杂志,2014,43(4):467-468.
6 池名,青雪梅,潘彦舒,等.120例抑郁症患者大脑多神经递质变化初探[J].中国中药杂志,2014,39(8):1516-1518.
7 司天梅,方贻儒,李涛,等.米氮平治疗抑郁障碍的临床使用[J].中国心理卫生杂志.2014,24(8):634-635.
8 高月霞,黄敬,李红光,等.脑电生物反馈联合米氮平治疗焦虑障碍的临床对照研究[J].四川精神卫生,2015,28(4):321-322.
9 路晶.生物反馈技术对影响代谢综合征相关因素的研究[D].天津:天津医科大学,2014.
2 欧秋明,邓思灵.米氮平联合草酸艾司西酞普兰片治疗抑郁症的临床疗效及安全性评价[J].2015,31(13):1252-1253.
3 中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3)[M].济南:山东科技出版社,2001.83-90.
4 蒋雷,冯凌.米氮平联合小剂量氨磺必利治疗抑郁症的对照研究[J].中华全科医学,2014,12(5):721-722.
5 张加强,刘飞虎,张燕,等.抑郁症36例患者5-HT、NE、DA水平检测及临床意义[J].陕西医学杂志,2014,43(4):467-468.
6 池名,青雪梅,潘彦舒,等.120例抑郁症患者大脑多神经递质变化初探[J].中国中药杂志,2014,39(8):1516-1518.
7 司天梅,方贻儒,李涛,等.米氮平治疗抑郁障碍的临床使用[J].中国心理卫生杂志.2014,24(8):634-635.
8 高月霞,黄敬,李红光,等.脑电生物反馈联合米氮平治疗焦虑障碍的临床对照研究[J].四川精神卫生,2015,28(4):321-322.
9 路晶.生物反馈技术对影响代谢综合征相关因素的研究[D].天津:天津医科大学,2014.