重复经颅刺激联合艾司西酞普兰治疗伴躯体症状抑郁症的临床效果

Clinical effect of repeated transcranial stimulation combined with Escitalopram in the treatment of depression with somatic symptoms

目的探讨重复经颅刺激(rTMS)联合艾司西酞普兰治疗伴躯体症状抑郁症的临床效果。方法选择2020年5月至2021年12月在吉安市第三人民医院接受治疗的92例伴躯体症状抑郁症患者为研究对象,按照随机数字表法分为对照组(46例)和试验组(46例),对照组脱落5例,最终对照组41例,试验组46例。对照组采用艾司西酞普兰治疗,试验组采用r TMS联合艾司西酞普兰治疗,疗程8周。比较两组患者的临床疗效、汉密尔顿抑郁量表-24(HAMD-24)、汉密尔顿焦虑量表(HAMA)及不良反应。结果治疗8周后,两组患者的总有效率比较,差异无统计学意义(P>0.05)。试验组治疗2、4、8周的HAMA评分低于对照组,差异有统计学意义(P<0.05);但两组治疗6周的评分比较,差异无统计学意义(P>0.05)。试验组治疗2、4、6、8周的HAMD-24评分低于对照组,差异有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论艾司西酞普兰联合r TMS治疗伴躯体症状抑郁症的疗效及安全性优于单用艾司西酞普兰。

Objective To investigate the clinical effect of repeated transcranial stimulation(rTMS)combined with Escitalopram in the treatment of depression with somatic symptoms.Methods A total of 92 patients with depression with physical symptoms who received treatment in Ji'an Third People's Hospital from May 2020 to December 2021 were selected as the research objects.According to the method of random number table,they were divided into control group(46 cases)and experimental group(46 cases),with 5 cases of detachment in the control group,41 cases in the final control group and 46 cases in the experimental group.The control group was treated with escitalopram,and the experimental group was treated with rTMS combined with Escitalopram,for 8 weeks.The clinical efficacy,Hamilton depression scale-24(HAMD-24),Hamilton anxiety scale(HAMA)and adverse reactions of the two groups were compared.Results After 8 weeks of treatment,there was no significant difference in the total effective rate between the two groups(P>0.05).HAMA scores of experimental group at 2,4 and 8 weeks were lower than those of control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the scores of the two groups after 6 weeks of treatment(P>0.05).HAMD-24 scores of experimental group at 2,4,6 and 8 weeks were lower than those of control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion The efficacy and safety of Escitalopram combined with rTMS in the treatment of depression with physical symptoms are superior to Escitalopram alone.