盐酸氟西汀联合重复经颅磁刺激治疗伴焦虑症状抑郁症的随机对照研究

A randomized controlled trial on fluoxetine combined with repetitive transcranial magnetic stimulation versus fluoxetine alone in the treatment of major depressive disorder with anxiety symptoms

目的:比较单用盐酸氟西汀或盐酸氟西汀联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗伴焦虑症状抑郁症患者的有效性及安全性。方法:102例伴有焦虑症状的抑郁症住院患者随机分为联合治疗组51例(rTMS联合盐酸氟西汀)和对照组(单用盐酸氟西汀)51例,疗程8周。采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)以及治疗中出现的症状量表(TESS)分别在基线、治疗后2、4、8周评估疗效及不良反应。结果:联合治疗组总有效率、HAMA、HAMD评分时间主效应、组间主效应及TESS评分优于对照组,差异有统计学意义(P<0.05)。结论:盐酸氟西汀联合rTMS治疗伴焦虑症状抑郁症的疗效及安全性优于单用盐酸氟西汀。

Objective:To compare the efficacy and safety of fluoxetine alone or fluoxetine hydrochloride combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of major depressive disorder(MDD)with anxiety symptoms.Methods:One hundred and two inpatients diagnosed as MDD with anxiety symptoms were randomly divided into the combination group(rTMS plus fluoxetine,51patients)and the control group(fluoxetine only,51patients).The course of treatment was8weeks.Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and the treatment emergent symptoms scale(TESS)were used to evaluate the efficacy and side effects at baseline,2,4and8weeks after treatment.Results:The total effective rate,HAMA and HAMD main effects of time and between groups,and the TESS score of the combined treatment group were better than those of the control group,and the differences were statistically significant(P<0.05).Conclusions:The efficacy and safety of fluoxetine hydrochloride combined with rTMS are better in the treatment of depression with anxiety symptoms than those of fluoxetine alone.