重复经颅磁刺激联合文拉法辛治疗产后抑郁症的对照研究

The association study of treating postpartum depression by repetitive transcranial magnetic stimulation combined with venlafaxine.

目的:观察重复经颅磁刺激(rTMS)联合文拉法辛缓释片治疗产后抑郁症的疗效和安全性及其副作用。方法:将58例产后抑郁症患者随机分为治疗组30例和对照组28例。两组均给予文拉法辛缓释片75 mg/d顿服,疗程4周。治疗组在此基础上应用重复经颅磁刺激治疗,以30%刺激强度刺激患者左额叶背外侧,频率为10 Hz,每日1次,连续治疗5点为1个疗程,疗程之间间隔2天,连续治疗4个疗程。治疗前和治疗后1、2、4周末采用HAMD量表评定抑郁症状,采用TESS量表评定副反应。结果:58例患者均完成治疗,两组HAMD评分在治疗2周末与治疗前比较差异均有统计学意义(P<0.05或P<0.01),治疗组在治疗第1周末即显示明显疗效(P<0.01)。治疗组有效率高于对照组(P<0.05)。两组均未观察到明显的副反应。结论:重复经颅磁刺激联合文拉法辛治疗产后抑郁症疗效显著,安全性好,可以提高疗效。

Objective： To explore the therapeutic effect and safety of treating postpartum depression by repetitive transcranial magnetic stimulation combined with venlafaxine. Methods： Fifty - eight cases of postpartum depression were randomly divided into treatment group （30 cases） and control group （28 cases） . Two groups were given venlafaxine extended release tablets 75 mg/d for four weeks. On the same time, the treatment group applied repetitive transcranial magnetic stimulation treatment, 30% stimulation intensity, frequency of 10Hz stimulation in patients with left dorsolateral frontal lobe, once a day, 5 days for a course, 2 days interval between treatment for 4 courses. HAMD rating scale were used to evaluate depression symptoms before and after treatment with 1, 2, 4 weekend. TESS rating scale were used to evaluate side effects. Results ： Fifty - eight patients were completed the treatment. There were significantly different in HAMD scores between the treatment of the 2 weeks and before treatment （P 〈 0. 05 or P 〈 0. 01 ） . Treatment group showed significant effect on the first weekend （ P 〈 0. 01 ） . The effectiveness in treatment group was higher than control groups （ P 〈 0. 05 ） . The significant side effects were not observed in the two groups. Conclusion： Repetitive transcranial magnetic stimulation combined with venlafaxine has significantly effect, safety, and can improve therapeutic effect in the treatment of postpartum depression.