加速重复经颅磁刺激治疗脑卒中后抑郁症患者的安全性及有效性

Safety and effectiveness of accelerated repetitive transcranial magnetic stimulation in the treatment of post-stroke depression

目的探究加速重复经颅磁刺激治疗脑卒中后抑郁症患者的安全性及有效性。方法收集我院住院脑卒中后抑郁症患者60例,符合ICD-10中脑卒中后的器质性抑郁障碍诊断标准,随机分为研究组和对照组。研究组为药物联合连续4d的加速重复经颅磁刺激治疗(5次/日,连续治疗4日);对照组为同样药物联合经典的重复经颅磁刺激治疗(1次/日,每周连续治疗5d,连续4周)。治疗前后检测患者的心率、血压和心电图、脑电图变化。治疗前后分别给予汉密尔顿抑郁量表比较临床疗效。结果研究组总有效率96.3%,对照组100%,两组间临床疗效差异无统计学意义(P>0.05),治疗6周后HAMD评分两组差异无统计学意义(P>0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论加速和标准rTMS治疗脑卒中后抑郁症的有效性和安全性没有显著差异。

Objective To explore the safety and effectiveness of accelerated repetitive transcranial magnetic stimulation in the treatment of post-stroke depression.Methods 57 outpatients and inpatients aged between 18 and 80 years with post-stroke depression in our hospital who met the ICD-10 diagnostic criteria for post-stroke organic depression were collected and randomly divided into the study group and the control group.The study group was treated with accelerated transcranial magnetic stimulation for 4 consecutive days(5 times/day x 4 days);The control group was treated with classic repetitive transcranial magnetic stimulation(Once a day,continuous treatment for 5 days a week,continuous treatment for 4 weeks).After each treatment,the patients were asked to check whether there are adverse reactions,and the changes of heart rate,blood pressure,electrocardiogram and EEG of the patients were detected before and after treatment.Comparison of clinical efficacy with Hamilton Depression(HAMD)Scale before and after treatment.Results After 6 weeks of treatment,the total effective rate was 96.3%in the study group and 100%in the control group.There was no statistical difference in HAMD scores between the two groups before and after treatment(P>0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The efficacy and safety of accelerated and standard rTMS in the treatment of PSD ultimately did not differ significantly.