经皮正中神经电刺激对轻中度抑郁患者的疗效研究

Efficacy of percutaneous median nerve stimulation for patients with mild-moderate depression

目的:观察经皮正中神经电刺激(MNES)对轻中度抑郁患者的临床疗效。方法:选取60例抑郁患者,按照随机数字表法分为对照组和MNES组,每组30例。2组患者均接受抗抑郁常规治疗,MNES组在此基础上行右MNES治疗,一只电极置于右侧腕关节掌面腕横纹上2cm正中神经点,另一只置于右侧大鱼际肌;单个刺激持续时间40s,间歇时间20s,30min/次/d,5次/周,共治疗6周。分别于治疗前及治疗后3周、6周对两组患者进行汉密尔顿抑郁量表(HAMD-24)、抑郁自评量表(SDS)及匹兹堡睡眠质量指数量表(PSQI)评定和比较,评价患者的抑郁、焦虑及睡眠情况。结果:治疗3周后,2组患者的HAMD-24及SDS评分均较治疗前降低(P<0.05),但2组间差异无统计学意义;治疗3周后,对照组患者的PSQI虽有降低趋势,但无统计学差异;治疗3周后,与治疗前比较,MNES组PSQI分降低明显(P<0.05),但与对照组比较无统计学差异。治疗6周后,2患者的HAMD-24、SDS及PSQI评分均较组内治疗前显著降低(均P<0.05),且MNES组的评分明显优于对照组(P<0.05)。结论:MNES治疗对抑郁患者存在一定的治疗效果,可改善其抑郁水平和睡眠质量,建议推广。

Objective:To observe the clinical efficacy of transcutaneous median nerve stimulation(MNES)for patients with mild-moderate depression.Methods:A total of 60 depressed patients admitted to our center from August 2018 to August 2019 were selected and divided into the control group(receiving conventional treatment)and the MNES group(given the right MNES on the basis of conventional treatment)according to the random number,30 cases in each group.Both groups of patients received conventional antidepressant treatment.In the MNES group,the right MNES treatment was performed on this basis.One electrode was placed on the 2 cm median nerve point on the palmar transverse stripes of the right wrist joint,and the other was placed on the right thenar muscle;single stimulation duration of 40 s,intermittent time of 20 s,30 min/time/day,5 times/week,a total of 6 weeks of treatment.The Hamilton Depression Scale(HAMD-24),Self-Rating Depression Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI)were used before and 3 weeks and 6 weeks after treatment to assess the depression,anxiety and sleep status of patients.Results:After 3 weeks of treatment,the HAMD-24 and SDS scores in the control group and the MNES group were significantly improved(P<0.05),and there was no significant difference between the two groups.After 3 weeks of treatment,although the PSQI score in the control group had a tendency to decrease,there was no statistical difference;after 3 weeks of treatment,the PSQI score in the MNES group was significantly lower than that before treatment(P<0.05),but there was no statistical difference between two groups.After 6 weeks of treatment,the HAMD-24,SDS and PSQI scores in the control group and MNES group were significantly improved as compared with those before the treatment(P<0.05),and the scores in the MNES group were significantly better than those in the control group(P<0.05).Conclusion:Median nerve stimulation therapy has a certain therapeutic effect on depressed patients,which can improve their depression level and sleep quality.It is recommended to promote it.