摘要
目的:探讨高频重复经颅磁刺激(rTMS)联合氟哌噻吨美利曲辛治疗脑卒中后抑郁(PSD)的疗效及安全性。方法:120例PSD患者,随机分为药物组(n=60)和联合组(n=60)。药物组患者接受氟哌噻吨美利曲辛和伪刺激,联合组患者接受氟哌噻吨美利曲辛和高频rTMS。对比观察两组抗PSD有效率、汉密尔顿抑郁量表(HAMD)评分、中国脑卒中量表(CSS)评分、健康调查简表(SF-36)评分、负性认知调查问卷评分及血清5-羟色胺(5-HT)、去甲肾上腺素(NE)、神经肽Y(NPY)、脑源性神经营养因子(BDNF)水平的差异。结果:治疗前,两组各指标差异均无统计学意义(P>0.05);治疗后,联合组抗PSD有效率高于药物组(93.33%vs 71.67%,P<0.01);两组HAMD评分、CSS评分较治疗前降低,SF-36评分较治疗前增高,且联合组改善情况优于药物组(P<0.01);两组负性注意、负性记忆、负性解释、负性反复思考等评分均较治疗前降低,且联合组较药物组降低更明显(P<0.01);两组血清5-HT、NE、NPY及BDNF水平均较治疗前增高,且联合组较药物组升高更明显(P<0.01);两组不良反应差异无统计学意义(P>0.05)。结论:高频rTMS联合氟哌噻吨美利曲辛治疗PSD临床效果显著,值得临床推广应用。
Objective: To explore the clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with flupentixol melitracen on post-stroke depression(PSD). Method: One hundred and twenty PSD patients were randomly divided into drug group(n=60) and combination group(n=60). The drug group received flupentixol melitracen and sham-stimulation, while the combined group received flupentixol melitracen and high-frequency rTMS. The differences in Anti-PSD effective rate, Hamilton depression scale(HAMD) score, Chinese stroke scale(CSS) score, SF-36 score and the serum levels of serotonin(5-HT), norepinephrine(NE), neuropeptide Y(NPY) and brain-derived neurotrophic factor(BDNF) between the two groups were observed and compared. Results: Before treatment, there was no statistical significance in each index between the two groups(P>0.05).The effective rate of anti-PSD in the combination group was higher than that in the drug group,and the difference was statistically significant(93.33% vs 71.67%,P<0.01).After treatment,HAMD score and CSS score decreased and SF-36 score increased in both groups,but the improvement in combination group was better than that in drug group(P<0.01).After treatment,the scores of negative attention,negative memory,negative interpretation and negative ruminating decreased in both groups,and the decrease was more obvious in the combination group than in the drug group(P<0.01).The serum levels of 5-HT,NE,NPY and BDNF in both groups after treatment were higher than before treatment,and the increase was more obvious in combination group than in drug group(P<0.01).There were no statistical significance in the adverse reactions between the two groups(P>0.05).Conclusion:High frequency rTMS combined with flupentixol meritracine in the treatment of PSD has a significant clinical effect,which is worthy of clinical application.
作者
刘双洁
吕铭新
王玉琴
梁军军
李婷婷
LIU Shuang-jie;LV Ming-xin;WANG Yu-qin;LIANG Jun-jun;LI Ting-ting(Department of Internal Neurology,,Fourth People's Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,China;Intensive Care Unit,Fourth People's Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,China)
出处
《微循环学杂志》
2021年第1期48-53,共6页
Chinese Journal of Microcirculation
基金
廊坊市科学技术研究与发展计划(2019013099)。
关键词
卒中后抑郁
重复经颅磁刺激
高频率
氟哌噻吨美利曲辛
负性认知
神经递质
脑源性神经营养因子
Post-stroke depression
Repetitive transcranial magnetic stimulation
High-frequency
Flupentixol melitracen
Negative cognition
Neurotransmitter
Brain-derived neurotrophic factor