探讨重复经颅磁刺激治疗双相抑郁的疗效和安全性

Discussion on the efficacy and safety of repeated transcranial magnetic stimulation on the treatment of bipolar depressive disorder

目的探究对双相抑郁(BDD)患者施以重复经颅磁刺激(rTMS)治疗的临床效果及安全性。方法 38例BDD患者,随机分为对照组及观察组,各19例。两组患者均接受拉莫三嗪治疗,在此基础上,对照组患者施以假刺激治疗,观察组患者施以rTMS进行联合治疗。比较两组患者的治疗效果、汉密尔顿抑郁量表(HAMD)和临床疗效总评量表-病情严重程度(CGI-SI)评分以及不良反应发生情况。结果观察组患者的总有效率为73.68%,高于对照组的42.11%,差异有统计学意义(P<0.05)。治疗前,两组患者的HAMD和CGI-SI评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者的HAMD和CGISI评分均较本组治疗前降低,且观察组降低程度优于对照组,差异均具有统计学意义(P<0.05)。观察组患者的不良反应发生率为5.26%,与对照组的10.53%比较,差异无统计学意义(P>0.05)。结论对BDD患者施以rTMS治疗可以早期改善患者的症状,提高治疗效果,安全性好,具有突出的临床应用价值。

Objective To investigate the clinical effect and safety of repeated transcranial magnetic stimulation(rTMS)on the treatment of patients with bipolar depressive disorder(BDD).Methods A total of 38 BDD patients were randomly divided into control group and observation group,with 19 cases in each group.Patients in both groups were treated with lamotrigine.Based on this,patients in the control group were treated with false stimulation,and patients in the observation group were treated with rTMS.The therapeutic effect,Hamilton depression scale(HAMD),clinical global impression-severity of illness(CGI-SI)score and occurrence of adverse reactions were compared between the two groups.Results The total effective rate was 73.68%in the observation group,which was higher than 42.11%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in HAMD and CGI-SI score between the two groups(P>0.05).After treatment,HAMD and CGI-SI score in the two groups were lower than those before treatment,and the reduction degree of the observation group was better than that of the control group.The difference was statistically significant(P<0.05).The incidence of adverse reactions was 5.26%in the observation group,which had no statistically significant difference compared with 10.53%in the control group(P>0.05).Conclusion Applying rTMS treatment to BDD patients can improve the symptoms of patients early,improve the therapeutic effect with high safety,and it contains outstanding clinical application value.