重复低频经颅磁刺激联合阿戈美拉汀治疗老年抑郁症的临床疗效

Clinical effect of repeated low frequency transcranial magnetic stimulation combined with agomelatine in the treatment of senile depression

目的观察重复低频经颅磁刺激联合阿戈美拉汀治疗老年抑郁症病人的疗效及其对血清去甲肾上腺素(norepinephrine,NE)、5-羟色胺(5-hydroxytryptamine,5-HT)水平的影响。方法选择2016年10月至2017年6月河北省第六人民医院住院的92例老年抑郁症病人,由于中途退出7例,最终实际纳入病人85例。按照随机数字表法分为对照组40例,观察组45例,2组病人均给予阿戈美拉汀片口服,在此基础上观察组加用重复低频经颅磁刺激治疗,观察治疗4、8周后2组病人血清5-HT、NE水平及汉密尔顿抑郁量表(HAMD)评分的变化。结果治疗前2组病人血清5-HT、NE水平及HAMD评分比较,差异无统计学意义(P>0.05)。治疗4、8周后,2组病人血清5-HT、NE水平比较差异无统计学意义(P>0.05);2组HAMD评分均较治疗前降低,且观察组较对照组降低更明显(P<0.05)。观察组总有效率(88.89%)明显高于对照组(72.50%),差异有统计学意义(P<0.05)。结论重复低频经颅磁刺激对老年抑郁症病人血清5-HT、NE水平无明显影响,联合应用阿戈美拉汀能明显降低老年抑郁症病人HAMD评分,改善临床抑郁症状,提高生活质量,且无明显不良反应。

Objective To observe the clinical efficacy and the influence on serum levels of 5-hydroxytryptamine(5-HT)and norepinephrine(NE)of repeated low frequency transcranial magnetic stimulation combined with agomelatine in the elderly patients with depression.Methods From October 2016 to June 2017,a total of 85 elderly patients with depression in the Sixth People’s Hospital of Hebei Province were randomly divided into the control group(n=40)and the observation group(n=45).Both groups were given agomelatine.The observation group was treated with repeated low frequency transcranial magnetic stimulation additionally.The levels of 5-HT and NE in the two groups and the score of Hamilton Depression Scale(HAMD)were observed and compared after 4 and 8 weeks of treatment.Results There was no significant difference in serum levels of 5-HT and NE before treatment and after 4 and 8 weeks of treatment in the two groups(P>0.05).There was no significant difference in the score of HAMD between the two groups before treatment.And the score of HAMD of the two groups at 4 and 8 weeks of treatment were lower than those before treatment,especially in the observation group(P<0.05).The total effective rate in the observation group(88.89%)was significantly higher than that in the control group(72.50%).Conclusions Repeated low frequency transcranial magnetic stimulation has no significant effect on serum levels of 5-HT and NE in elderly patients with depression.Combination of agomelatine can significantly reduce HAMD score and improve clinical symptoms of depression and the quality of life,with no obvious adverse reactions.