TBS模式rTMS联合舍曲林治疗对青少年抑郁症患者情绪和认知功能的影响

Effects of TBS mode rTMS combined with sertraline on mood and cognitive function in adolescent patients with depression

目的探讨θ短阵快速脉冲刺激(theta burst stimulation,TBS)模式重复经颅磁刺激(repetitive transcranial magnetic stimulation,r TMS)联合舍曲林对青少年抑郁症患者精神症状和认知功能的影响。方法青少年抑郁症患者100例,随机分为对照组与观察组,每组50例。两组均予以舍曲林治疗,同时观察组予以TBS模式的r TMS刺激治疗,对照组予以r TMS伪刺激,两组均连续治疗4周。于治疗前和治疗后,对患者进行17项汉密尔顿抑郁量表(17 Hamilton Depression Scale,HAMD-17)评分、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、威斯康星卡片分类测量(Wisconsin Card Sorting Test,WCST)的评定,比较两组临床疗效和各项指标差异,并观察不良反应。结果观察组治疗总有效率为90.00%,与对照组的74.00%相比增高显著(P<0.05)。治疗后,相比对照组,观察组HAMD-17评分和HAMA评分显著降低(P<0.05)。治疗后,观察组WSCT错误反应数、持续错误数显著低于对照组(P<0.05),WCST完成分类数显著高于对照组(P<0.05)。结论TBS模式r TMS联合舍曲林治疗青少年抑郁症患者,能够更有效地缓解患者精神症状,改善其认知功能。

Objective To investigate the effects of theta burst stimulation(TBS)mode repetitive transcranial magnetic stimulation(rTMS)combined with sertraline on psychiatric symptoms,and cognitive function in adolescent patients with depression.Methods A total of 100 adolescent patients with depression were randomly divided into control group and observation group,with 50 cases in each group.Both groups were treated with sertraline,while the observation group was treated with TBS mode rTMS stimulation,and the control group was treated with rTMS pseudo stimulation.Both groups were treated continuously for 4 weeks.Before and after treatment,the patients were assessed for psychiatric symptoms[17 Hamilton Depression Scale(HAMD-17)score,Hamilton Anxiety Scale(HAMA)].The clinical efficacy and differences in various indicators were compared between the two groups,and adverse reactions were observed.Results The total effective rate of the observation group was 90.00%,which was significantly higher than 74.00%of the control group(P<0.05).After treatment,compared with the control group,the HAMD-17 score and HAMA score of the observation group were significantly lower(P<0.05).After treatment,the number of WCST error reactions and persistent errors in the observation group were significantly lower than those in the control group(P<0.05),and the number of WCST completed classifications were significantly higher than those in the control group(P<0.05).Conclusion TBS mode rTMS combined with sertraline in the treatment of adolescent depression patients can more effectively alleviate the mental symptoms of patients and improve their cognitive function.