重复经颅磁刺激联合盐酸帕罗西汀对抑郁症患者生活质量及血清NPY、BDNF与5-HT水平的影响

Effects of Repetitive Transcranial Magnetic Stimulation Combined with Paroxetine Hydrochloride on Quality of Life and Serum Levels of NPY,BDNF and 5-HT in Patients with Depression

目的:探讨重复经颅磁刺激(r TMS)联合盐酸帕罗西汀治疗抑郁症患者的临床疗效及对患者生活质量和血清神经肽Y(NPY)、脑源性神经营养因子(BDNF)、5-羟色胺(5-HT)水平的影响。方法:选取2017年2月~2019年3月期间北京回龙观医院收治的91例抑郁症患者,按数表法将患者随机分为对照组(n=45)和研究组(n=46),对照组给予盐酸帕罗西汀治疗,研究组在对照组的基础上联合r TMS治疗,比较两组患者临床疗效、生活质量、汉密尔顿抑郁量表(HAMD)评分、血清相关指标及不良反应。结果:治疗4周后,研究组临床总有效率较对照组升高(P<0.05)。两组治疗4周后HAMD量表评分均下降,且研究组低于对照组(P<0.05)。两组治疗4周后躯体角色、社会功能、情感职能、精力、精神健康、一般健康、躯体疼痛、躯体机能评分均升高,且研究组高于对照组(P<0.05)。两组治疗4周后血清NPY、BDNF、5-HT水平均升高,且研究组高于对照组(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。结论:r TMS联合盐酸帕罗西汀治疗抑郁症疗效显著,可改善患者的临床症状、生活质量以及血清NPY、BDNF、5-HT水平,安全性较好,具有一定的临床应用价值。

Objective: To investigate the clinical efficacy of repetitive transcranial magnetic stimulation(r TMS) combined with paroxetine hydrochloride in the treatment of depression and its effects on the quality of life and serum levels of neuropeptide Y(NPY),brain-derived neurotrophic factor(BDNF) and 5-hydroxytryptamine(5-HT) in patients with depression. Methods: 91 patients with depression who were admitted to Huilongguan Hospital of Beijing from February 2017 to March 2019 were selected, they were divided into control group(n=45) and study group(n=46) according to random number table method. The control group was treated with paroxetine hydrochloride, and the study group was treated with r TMS on the basis of the control group. The clinical efficacy, quality of life, Hamilton Depression Scale(HAMD) score, serum related indicators and adverse reactions were compared between the two groups. Results: 4 weeks after treatment, the total clinical effective rate of the study group was higher than that of the control group(P<0.05). 4 weeks after treatment, the scores of HAMD scale of both groups decreased at 4 weeks after treatment, and that in the study group was lower than that in the control group(P<0.05). 4 weeks after treatment, the scores of physical role, social function, emotional function, energy, mental health, general health, physical pain and physical function in both groups increased, and the scores in the study group were higher than those in the control group(P<0.05). Serum levels of NPY, BDNF and 5-HT were increased in both groups at 4 weeks after treatment, and that in the study group were higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: The r TMS combined with paroxetine hydrochloride is effective in the treatment of depression. It can improve the clinical symptoms, quality of life and serum levels of NPY, BDNF and 5-HT. It is safe, and it has certain clinical application value.