帕罗西汀联合低频重复经颅磁刺激治疗抑郁症的对照研究

The control study of paroxetine combined with low frequency repetitive transcranial magnetic stimulation in treatment of major depression disorder

目的:探讨帕罗西汀联合低频重复经颅磁刺激(r TMS)治疗抑郁症的疗效及安全性。方法:60例抑郁症患者随机分为研究组和对照组各30例,研究组在接受帕罗西汀治疗的同时联合低频(1Hz)r TMS,对照组则单一帕罗西汀,疗程均为6周。分别在基线、治疗2,4、6周末对患者进行汉密尔顿抑郁量表(HAMD)以及治疗中出现的症状量表(TESS)评定。结果:治疗2周与4周末,研究组HAMD总分、焦虑/躯体化、绝望感因子,以及抑郁情绪、自杀、躯体性焦虑、精神性焦虑条目评分显著低于对照组,差异有统计学意义(P均<0.05);治疗6周末HAMD评分两组差异无统计学意义(P>0.05)。两组不良反应发生率分别为26.7%和30%(P>0.05)。结论:帕罗西汀联合低频r TMS治疗抑郁症较单一帕罗西汀起效快,能早期改善患者抑郁、焦虑情绪。

Objective： To explore the efficacy and safety of combined low frequency repetitive transcranial magnetic stimulation （rTMS） and paroxetine in the treatment of major depression disorder. Method ： Sixtymajor depression disorder patients were assigned to 2 groups randomly,the research group （30 cases） was treated with paroxetineand and low frequencyrTMS, and the control group （30 cases） was treated with paroxetine singly. The research lasted for 6 weeks. Hamilton depression scale （HAMD） was used to evaluate the efficiency of the treatment at the baseline,2 weeks ,4 weeks and the endpoint, meanwhile treatment emergent symptoM scale （TESS） was used to evaluate the adverse effects. Results：At the 2nd and 4th week,the research group showed lower HAMD total score, anxiety/somatization, feeling of despair score than the control group, and lower HAMD item scores including depression, suicide, somatic anxiety and psychic anxiety than the control group（ all P 〈 0.05 ）. At the 6th week,the HAMD and TESS score differences of the two groups were not statistically significant （P 〉 0.05 ）. The ratio of the adverse effect of the two groups were 26.7% and 30% （P 〉 0.05 ）. Conclusion ： The combination of paroxetine and low frequency rTMS for major depression disorder presents earlier response, improves depression mood and anxiety early.