低频重复经颅磁刺激治疗首发抑郁症的临床对照研究

A controlled clinical ctudy of rTMS in treatment of first- episode depression

目的探讨低频重复经颅磁刺激(rTMS)治疗首发抑郁症的疗效及安全性。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的65例首发抑郁症患者分为rTMS组33例和氟西汀组32例,观察期6周。用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)及副反应量表(TESS)分别评定疗效及不良反应。结果 rTMS组有效率78.8%,氟西汀组有效率84.4%,两组疗效相当(P>0.05);在第1周末rTMS组HAMD-17和HAMA评分较氟西汀组低,差异有统计学意义(P<均0.05);rTMS组和氟西汀组不良反应发生率分别为12.1%和40.6%,差异有统计学意义(P<0.01)。结论 rTMS治疗首发抑郁症的效果与氟西汀相当,但起效较氟西汀快、不良反应发生率低于氟西汀。

Objective To explore the efficacy and safety of slow repetitive transcranial magnetive stimulation （rTMS） for patients with first - episode depression. Methods 65 patients with first - episode depression were randomly divided into rTMS group （ 33 cases treated with rTMS） and fluoxetine group （32cases treated with fluoxetine） for 6 weeks. The efficacy was assessed with HAMD17 and HAMA, while the adverse reactions were assessed with TESS. Results The effective rate of rTMS group is 78.8%. The effective rate of fluoxetine group is 84.4%. There is no difference between the two groups in efficacy （ P 〉 0.05 ）. While the scores of the HAMDI7 and HAMA in rTMS group significantly decreased than those in fluoxetine group at the end of the first week（P 〈 0.05 ）. The incidence of adverse reaction is 12.1% in rTMS group, while the incidence of adverse reaction is 40.6% in fluoxetine group. There are obvious difference between the two groups on adverse reactions （ P 〈 0.01 ）. Conclusion rTMS takes effect faster than fluoxetine, the incidence of adverse reaction is less than fluoxetine, and it is as effective as fluoxetine in treatment of first - episode depression.