重复经颅磁刺激联合抗抑郁药对首发抑郁症患者早期疗效及认知功能的影响

Effects of repetitive transcranial magnetic stimulation combined with antidepressants on early efficacy and cognitive function in patients with first-episode depression

目的分析重复经颅磁刺激(rTMS)联合抗抑郁药对抑郁症首次发病患者的早期疗效及认知功能的影响。方法选取新乡市某医院2017年12月-2019年12月收治的86例抑郁症首次发病患者为研究对象,按照随机数字表法分为对照组和观察组,各43例。对照组患者予以帕罗西汀治疗,观察组患者在对照组基础上予以rTMS治疗,治疗4周。比较2组患者治疗前后的认知功能、疗效及不良反应发生情况,比较治疗2周、4周时汉密尔顿抑郁量(HAMD-17)评分。结果对照组患者治疗总有效率为74.42%,观察组患者治疗总有效率为93.02%。观察组患者早期疗效明显高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者HAMD-17评分比较,差异无统计学意义(P>0.05)。治疗2周及4周时,2组患者HAMD-17评分均低于治疗前,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者记忆功能、注意功能、执行功能比较,差异均无统计学意义(P>0.05)。治疗后,观察组患者执行功能中的分类完成数较治疗前增加,且明显高于对照组,差异均有统计学意义(P<0.05)。对照组患者发生不良反应15例,不良反应发生率为34.86%。观察组患者发生不良反应10例,不良反应发生率为23.26%。2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论rTMS与抗抑郁药联合治疗抑郁症首次发病患者的效果显著,且安全性高,值得临床推广。

Objective To analyze the effects of repetitive transcranial magnetic stimulation combined with antidepressants on the early efficacy and cognitive function of patients with the first-episode depression.Methods Eighty-six patients with the first-episode depression admitted to a hospital in Xinxiang from December 2017 to December 2019 were selected for the study and divided into a control group and an observation group using a random number table,with 43 cases in each.Patients in the control group were treated with paroxetine,and patients in the observation group were treated with repeated transcranial magnetic stimulation in addition,both for 4 weeks.The efficacy,cognitive function and the occurrence of adverse effects of the two groups were compared before and after treatment,and the Hamilton depression rating scale(HAMD-17)scores at 2 and 4 weeks of treatment were compared.Results The total effective rate of treatment was 74.42%in the control group and 93.02%in the observation group,and the early efficacy of the observation group was significantly higher than that of the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference between the HAMD-17 scores of patients in the 2 groups(P>0.05).At 2 and 4 weeks of treatment,the HAMD-17 scores of patients in the 2 groups were lower than those before treatment,and those of patients in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,the differences were not statistically significant(P>0.05)when comparing memory function(memory quotient,total WMS-RC score),attention function(net NCT score,error rate),and executive function(number of correct responses,number of persistent errors,number of random errors,and number of classification completion)between the 2 groups.After treatment,the number of classification completion in the executive function of patients in the observation group increased compared with that before treatment and was significantly higher than that in the control group,and the differences were all statistically significant(P<0.05).There were 15 cases of adverse reactions in patients in the control group,and the incidence of adverse reactions was 34.86%.There were 10 cases of adverse reactions in the observation group,and the incidence of adverse reactions was 23.26%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of TMS and antidepressants is effective and safe in treating patients with first-episode depression and is worthy of clinical promotion and use.