无痉挛电休克及重复经颅磁刺激治疗难治性抑郁症的临床疗效比较

The Comparison of Clinical Efficacy between Modified Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation on the Patients with Treatment Resistant Depression

目的比较无痉挛电休克(m ECT)和重复经颅磁刺激(r TMS)对于改善难治性抑郁症住院患者的临床疗效。方法选取我院住院治疗的难治性抑郁症患者64例,按照年龄、性别和汉密尔顿抑郁量表(HDRS)评分进行配对,每对患者随机选择进行m ECT治疗或r TMS治疗,治疗周期均为4周,治疗后均进行HDRS测量。结果两组治疗后的HDRS评分均较治疗前有大幅度下降(P<0.05),但是m ECT组的减分明显高于r TMS组(t=4.271,P=0.001);r TMS治疗在改善患者的认知障碍上优于m ECT治疗,而m ECT治疗在改善迟缓和绝望感方面更为突出。结论 m ECT治疗和r TMS治疗均可有效缓解难治性抑郁患者的临床症状,但是m ECT的即时疗效明显高于r TMS治疗。

Objective To compare the clinical effects of the modified electroconvulsive therapy （mECT） and repetitive transcranial stimulation （rTMS） on the inpatients with treatment resistant depression （TRD）. Methods There were 64 inpatients with TRD, who were equipped with 32 pairs by age, gender and the score of Hamilton Depression Rating Scale （ HDRS ） . In each pair, the patient was chosen to be treated with mECT or rTMS by random. Both the two treatments lasted 4 weeks and the HDRS was assessed shortly after the end of the treatments. Results Both the treatment by mECT and rTMS declined the score of HDRS （P〈0.05）, but the mECT was superior on the redcution of HDRS （t=4.271, P=0.001 ）; as to the improvement of cognitive function, the rTMS was more competitive, while the mECT did much better on the items of ＂retardation＂ and ＂suicide ideation＂. Conclusions Both the treatment of mECT and rTMS could improve the severity of TRD effectively, but the mECT has a better therapeutic effect on TRD.