高频rTMS联合舍曲林治疗首发青少年抑郁症的疗效分析

High-frequency rTMS combined with sertraline in the treatment of first-episode adolescent depression

目的探讨高频重复经颅磁刺激(rTMS)联合舍曲林治疗首发青少年抑郁症的疗效,为患者诊疗提供依据。方法选择2017年3月~2019年3月首发青少年抑郁症患者60例作为研究对象。采用随机数字表法分两组,每组30例。对照组采用舍曲林治疗,观察组采用舍曲林联合高频rTMS治疗。治疗4周,比较治疗效果及汉密尔顿抑郁量表(HAMD)评分、临床疗效总评量表(CGIS)评分变化,统计不良反应。结果治疗后,观察组总有效率为93.33%,明显高于对照组的73.33%,差异有统计学意义(P<0.05);治疗1周、4周后,患者的HAMD评分、CGIS评分均明显降低,且观察组[(22.12±1.98)分、(15.12±2.10)分][(3.02±0.41)分、(1.87±0.21)分]均明显低于对照组[(24.88±2.01)分、(19.12±2.13)分][(4.12±0.52)分、(2.57±0.32)分],差异有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论高频rTMS联合舍曲林治疗首发青少年抑郁症可有效改善患者临床症状,疗效显著,安全性高,可在临床推广应用。

Objective To explore the efficacy of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with sertraline in the treatment of first-onset adolescent depression,and to provide evidence for diagnosis and treatment of patients.Methods 60 patients with first-episode adolescent depression from March 2017 to March 2019 were selected as the research objects.Random number table method was used to divide into two groups,30 cases in each group.The control group was treated with sertraline,and the observation group was treated with sertraline combined with high-frequency rTMS.After 4 weeks of treatment,the treatment effect and the changes in Hamilton Depression Scale(HAMD)score and Clinical Efficacy Scale(CGIS)score were compared,and adverse reactions were counted.Results After treatment,the total effective rate in the observation group was 93.33%,which was significantly higher than 73.33% in the control group,and the difference was statistically significant(P<0.05).After 1 week and 4 weeks of treatment,the patients'HAMD score and CCIS score decreased,and the observation group[(22.12±1.98)points,(15.12±2.10)points],[(3.02±0.41)points,(1.87±0.21)points] were significantly lower than the control group[(24.88±2.01)points,(19.12±2.13)points],[(4.12±0.52)points,(2.57±0.32)points],the difference was statistically significant(P<0.05).Compared with the incidence of adverse reactions between the two groups,the difference was not statistically significant(P>0.05).Conclusion High-frequency rTMS combined with sertraline can effectively improve the clinical symptoms of patients with first-onset adolescent depression,with significant curative effect and high safety,and can be used in clinical applications.