重复经颅磁刺激对首发抑郁症患者疗效及认知功能的影响

Influences of escitalopram plus repetitive transcranial magnet-ic stimulation on the therapeutic effect and cognitive function of first-episode de- pression patients

目的探讨艾司西酞普兰联合重复经颅磁刺激对首发抑郁症患者临床疗效及认知功能的影响。方法将70例首发抑郁症患者随机分为两组，每组35例。研究组予以艾司西酞普兰联合重复经颅磁刺激治疗，对照组予以艾司西酞普兰联合伪刺激治疗，观察4周。于治疗前后采用汉密顿抑郁量表及威斯康星卡片分类测验评定临床疗效及认知功能，统计不良反应发生状况。结果治疗后两组汉密顿抑郁量表评分均较治疗前显著降低（P〈0．01），研究组显著低于对照组（P〈0．01）；研究组威斯康星卡片分类测验的正确反应数、完成分类数较治疗前显著升高（P〈0．01），且显著高于对照组（P〈0．05），对照组则无显著变化（P〉0．05）。治疗期间两组未出现明显不良反应。结论艾司西酞普兰联合重复经颅磁刺激治疗首发抑郁症疗效显著，且能有效改善患者的认知功能，安全性高，优于单用艾司西酞普兰治疗。

Objective To explore the influences of escitalopram plus repetitive transcranial magnetic stimu- lation （rTMS） on the therapeutic effect and cognitive function of first-episode depression patients. Methods Seventy first-episode depression patients were randomly divided into two groups of 35 ones each. Research group was treated with escitalopram plus rTMS and control group with escitalopram plus pseudo-stimula- tion for 4 weeks. Efficacies and cognitive functions were assessed with the Hamilton Depression Scale （HAMD）and Wisconsin Card Sorting Test （WCST）before and after treatment, adverse reactions were added up. Results After treatment the HAMD score of both groups lowered more significantly compared with pretreatment （P〈0.01）, that was significantly lower in research than control group （P〈0.01） ; the numbers of correct reactions and complete classifications heightened more significantly in research com- pared with pretreatment （P〈0.01） and were significantly higher than in control group （P〈0.05）, those had no significant differences in control group （P〉0.05）. Both groups had no notable adverse reactions during treatment. Conclusion Escitalopram plus rTMS has an evident effect, could effectively improve patients＇ cognitive functions, and has higher safety compared with single escitalopram in first-episode de- pression patients.