低频重复经颅磁刺激联合心理疗法治疗脑梗死后抑郁症临床观察

Clinical Observation on Low-frequency Repetitive Transcranial Magnetic Stimulation and Psychotherapy in the Treatment of Post-stroke Depression

目的观察低频重复经颅磁刺激联合心理疗法治疗脑梗死后抑郁症的临床疗效。方法回顾性分析脑梗死后抑郁症患者120例,按照治疗方法不同分为观察组(采取低频重复经颅磁刺激联合心理疗法)和对照组(基础治疗加心理疗法加氟西汀口服),以4周为1个疗程。观察治疗前后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、汉密尔顿焦虑量表(HAMA)、生活质量指数(Barthel)和安全性指标的变化。结果治疗组治疗后平均HAMD、SDS和HAMA评分较治疗前和对照组明显降低(P<0.05);两组患者的Barthel积分比治疗前积分有明显升高(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗组总有效率为90.0%,与对照组(78.3%)比较差异有统计学意义(P<0.05)。结论低频重复经颅磁刺激对脑梗死后抑郁患者的抑郁症状和神经功能均有明显的治疗作用,并对焦虑症状也有一定的改善作用。

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation （rTMS）and psychother-apy in the treatment for patients with post stroke depression （PSD）.Methods One hundred and twenty patients with PSD,accord-ing to the method of treatment,were divided into two groups：The control group treated with routine treatment plus psychotherapy,and the treatment group treated with low frequency rTMS plus psychotherapy for 4 weeks.The Hamilton Rating Scale for Depression （HAMD）,self rating depression （SDS）,Hamilton anxiety rating scale （HAMA）,Barthel index（BI）and safety index were observed before and after treatment.Results After treatment,the scores of HAMD,SDS and HAMA in treatment group were significantly lower compared with the control group and before treatment（P〈0.05）.The BI were increased after treatment（P〈0.05）,but there was no differences between two groups（P〉0.05）.The total clinical effective rate was 90.0% in treatment group,which was higher than that in control group（78.3%,P〈0.05）.Conclusion Low frequency rTMS had significant therapeutic effect and could improve anxiety certain symptoms ment in patients with PSD.