两种非药物疗法治疗首发抑郁症的临床疗效和安全性研究
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摘要
目的研究分析两种非药物疗法--重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)和无抽搐电休克(modified electroconvulsive therapy,MECT)治疗首发抑郁症的临床疗效和安全性,为临床医师选择合理治疗方案提供参考。方法选择本院于2017年1月至2018年1月期间收治的90例首发抑郁症患者为此次研究对象,根据随机数字表法将所有患者分为两组,每组45例。分别采用rTMS治疗(实验组)、MECT治疗(对比组),比较两种非药物疗法的总有效率、不良反应发生率以及治疗前后汉密尔顿抑郁量表(HAMD)评分。结果治疗后,实验组患者的治疗总有效率为93.33%,明显高于对比组(77.78%),差异具有统计学意义(P<0.05);实验组不良反应发生率为8.89%,显著低于对比组(26.67%),差异有统计学意义(P<0.05);两组治疗前HAMD评分比较,差异无统计学意义;治疗后,两组HAMD评分均较治疗前降低,且实验组HAMD评分为(6.25±2.15)分,明显低于对比组,差异有统计学意义(P<0.05)。结论 rTMS和MECT对首发抑郁症均有较好疗效,但相较于MECT疗法,rTMS用于治疗首发抑郁症的临床疗效更佳,且安全性更高,值得在今后临床治疗中广泛推广并使用。
Objective To study and analyze the clinical efficacy and safety of two non-drug therapies, repetitive transcranial magnetic stimulation(rTMS) and modified electroconvulsive therapy(MECT), in the treatment of first-episode depression, and to provide references for clinicians in choosing reasonable treatment options. Methods 90 cases with first-episode depression admitted to our hospital from January 2017 to January 2018 were selected as the subjects. All patients were divided into two groups according to random number table method, 45 cases in each group. The total effective rate, the incidence of adverse reactions and the Hamilton Depression Scale(HAMD) score before and after treatment were compared between rTMS treatment(experimental group) and MECT treatment(control group). Results After treatment, the total effective rate of the experimental group was 93.33%, significantly higher than that of the control group(77.78%), the difference was statistically significant(P<0.05); the incidence of adverse reactions in the experimental group was 8.89%, significantly lower than that in the control group(26.67%), the difference was statistically significant(P<0.05); After treatment, the HAMD scores of the two groups were lower than those before treatment, and the HAMD scores of the experimental group were(6.25±2.15) points, significantly lower than those of the control group, the difference was statistically significant(P<0.05). Conclusion rTMS and MECT have better curative effect on first-episode depression, but compared with MECT, rTMS has better clinical effect and higher safety, which is worth popularizing and using in future clinical treatment.
Objective To study and analyze the clinical efficacy and safety of two non-drug therapies, repetitive transcranial magnetic stimulation(rTMS) and modified electroconvulsive therapy(MECT), in the treatment of first-episode depression, and to provide references for clinicians in choosing reasonable treatment options. Methods 90 cases with first-episode depression admitted to our hospital from January 2017 to January 2018 were selected as the subjects. All patients were divided into two groups according to random number table method, 45 cases in each group. The total effective rate, the incidence of adverse reactions and the Hamilton Depression Scale(HAMD) score before and after treatment were compared between rTMS treatment(experimental group) and MECT treatment(control group). Results After treatment, the total effective rate of the experimental group was 93.33%, significantly higher than that of the control group(77.78%), the difference was statistically significant(P<0.05); the incidence of adverse reactions in the experimental group was 8.89%, significantly lower than that in the control group(26.67%), the difference was statistically significant(P<0.05); After treatment, the HAMD scores of the two groups were lower than those before treatment, and the HAMD scores of the experimental group were(6.25±2.15) points, significantly lower than those of the control group, the difference was statistically significant(P<0.05). Conclusion rTMS and MECT have better curative effect on first-episode depression, but compared with MECT, rTMS has better clinical effect and higher safety, which is worth popularizing and using in future clinical treatment.
引文
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[8]普恩盛,廖助雄.改良无抽搐电休克疗法对难治性抑郁症(TRD)患者认知功能的影响与安全性分析[J].系统医学,2017,2(10):27-29.
[9]王伟,徐清,周园园.两种无抽搐电休克治疗模式对抑郁症患者疗效及记忆力影响的比较[J].临床精神医学杂志,2017,27(5):311-313.
[10]钟智勇,陶炯,王相兰,等.抗抑郁药物联合短期无抽搐电休克治疗对抑郁症疗效及认知功能的影响[J].中国临床药理学与治疗学,2017,22(2):179-183.
[2]蒲丽,向波,梁雪梅,等.低频重复经颅磁刺激与无抽搐电休克治疗精神分裂症患者的疗效及白质完整性分析[J].实用医学杂志,2017,33(19):3243-3247.
[3]孙秀媛,李海玲,朱相华,等.rTMS及MECT在不同时间点对抑郁症疗效和BDNF的影响及相关性研究[J].徐州医学院学报,2017,37(4):262-265.
[4]蔡珊,陶筱琴,陈桂梅.无抽搐电休克治疗对抑郁症病人认知功能的影响[J].护理研究,2017,31(23):2942-2944.
[5]张琦,郭银淼,王慧娟,等.无抽搐电休克治疗难治性抑郁症疗效及对患者自杀意念改善情况观察[J].山东医药,2017,57(43):42-44.
[6]谢琴,王高华,刘连忠,等.无抽搐电休克治疗老年难治性抑郁症临床研究[J].精神医学杂志,2016,29(1):9-12.
[7]陈英,洪道先,郑孝振,等.氯胺酮联合无抽搐电休克在治疗难治性抑郁症中对血清脑源性神经营养因子和认知功能的影响[J].安徽医药,2017,21(6):1113-1116.
[8]普恩盛,廖助雄.改良无抽搐电休克疗法对难治性抑郁症(TRD)患者认知功能的影响与安全性分析[J].系统医学,2017,2(10):27-29.
[9]王伟,徐清,周园园.两种无抽搐电休克治疗模式对抑郁症患者疗效及记忆力影响的比较[J].临床精神医学杂志,2017,27(5):311-313.
[10]钟智勇,陶炯,王相兰,等.抗抑郁药物联合短期无抽搐电休克治疗对抑郁症疗效及认知功能的影响[J].中国临床药理学与治疗学,2017,22(2):179-183.