重复经颅磁刺激合并米氮平治疗难治性抑郁症的临床研究

Clinical Study on rTMS and Mirtazapine in the Treatment of Treatment-Resistant Depression

目的对重复经颅磁刺激(rTMS)合并抗抑郁药治疗难治性抑郁症进行临床研究,探讨其疗效及安全性。方法将30例难治性抑郁症患者随机分为rTMS真刺激组和rTMS假刺激组,刺激左额叶前部背外侧(DLPFC),每周5次,共干预20次,同时合并使用米氮平治疗,于基线及治疗4周后应用汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI)评分,对比两组的疗效、不良反应情况。结果真刺激组治疗后的HAMD和CGI评分下降明显,与假刺激组相比有显著性差异(P<0.05),且无严重不良反应。结论重复经颅磁刺激(rTMS)合并米氮平治疗难治性抑郁症效果明显,安全可靠,具有广阔的应用前景。

Objective To explore the efficacy and safety of repetitive transcranial magnetic stimulation （rTMS） combining with antidepressant in the treatment of treatment-resistant depression （TRD）. Methods Thirty patients with TRI） were randomly divided into a real rTMS group and a sham rTMS group, both with Mirtazapine treatment. Each patient in the real rTMS group received 20 rTMS sessions over 4 weeks to the left dorsolateral prefrontal cortex. Hamilton Depression Scale （HAMD） and Clinical Global Impression Scale （CGI） were used to assess the therapeutic effect of two treatment methods at baseline and at 4 weeks after treatment. Adverse reactions were observed and recorded in a 4 weeks＇ duration. Results There was significant improvement in the rea~ rTMS group, as measured by scores on the HAMD and CGI. The difference between the real rTMS group and the sham rTMS group was significant （P〈0.05）. There was no serious adverse reaction. Conclusions As an effective and safe treatment for treatment-resistant depression, repetitive transcranial magnetic stimulation （rTMS） combining with Mirtazapine has broad application prospects.