重复经颅磁刺激联合艾司西酞普兰治疗对老年抑郁患者认知功能的影响

The Effect of Repetitive Transcranial Magnetic Stimulation Combined with Drugs on Cognitive Function in Senile Depression Patients

目的:探讨重复经颅磁刺激(rTMS)联合艾司西酞普兰治疗对老年抑郁症患者认知功能的疗效。方法:103例老年抑郁症患者随机分为两组,研究组49例,对照组54例,两组均给予艾司西酞普兰治疗,研究组在艾司西酞普兰治疗的基础上联合rTMS治疗,每周5次,2周为一个疗程,治疗4周。分别于治疗前、治疗4周后采用汉密尔顿抑郁量表(HAMD)和威斯康星卡片分类测验(WSCT)对治疗效果进行评价。结果:两组患者治疗前HAMD评分差异无统计学意义(P>0.05),治疗后两组的HAMD评分均有不同程度的降低,但研究组更明显(P<0.05);两组患者治疗前WSCT评分差异无统计学意义,治疗后研究组WCST量表中总测验次数、正确应答数因子评分明显高于对照组;错误应答数、持续错误数、分类数等因子评分均明显低于对照组,差异有统计学意义(P<0.05)。结论:rTMS联合艾司西酞普兰治疗可以改善老年抑郁症患者的抑郁情绪,对工作记忆、持续注意力及认知加工能力也有积极的作用。

Objective To explore the efficacy of repetitive transcranial magnetic stimulation（ rTMS） combined with drugs on cognitive function in senile depression patients. Methods 103 cases of senile depression were randomly divided into two groups. The study group was 49 cases,the control group 54 cases,and the two groups were treated with drugs. The study group was treated with rTMS on the basis of conventional medication for 4 weeks,5 times a week,2 weeks as a course of treatment. The treatment effect was evaluated by the Hamilton Depression Scale（ HAMD） and the Wisconsin card classification test（ WSCT） before and after 4 weeks of treatment. Results There was no significant difference in HAMD scores between the two groups（ P〉0.05）. The HAMD scores of the two groups were reduced in varying degrees after treatment,but the study group was more obvious（ P〈0.05）. There was no significant difference in WSCT scores before treatment between the two groups. After the treatment,the total number of tests and the number of correct response factors in the WCST scale of the study group were significantly higher than those of the control group; the number of false responses,persistent errors,and the number of categories were significantly lower than those of the control group. The scores of error reply number,continuous error number and classification number were significantly lower than those of the control group,and the difference was statistically significant（ P〈0.05）. Conclusions rTMS combined with drug therapy can improve the clinical symptoms of senile patients with depressions,and it also has positive implications for working memory,sustained attention and cognitive processing ability.