度洛西汀联合重复经颅磁刺激对重度抑郁症患者神经递质及认知功能的影响

Impacts of duloxetine combined with repetitive transcranial magnetic stimulation on neurotransmitters and cognitive function in patients with severe depression

目的:探讨度洛西汀联合重复经颅磁刺激对重度抑郁症患者神经递质水平及认知功能的影响。方法:将200例重度抑郁症患者随机分为对照组和联合组各100例。对照组采用盐酸度洛西汀肠溶胶囊治疗,联合组在对照组的基础上采用重复经颅磁刺激治疗,比较2组治疗后的疗效及治疗前后患者的认知功能和神经递质水平变化。结果:治疗6周后,2组患者汉密顿抑郁量表(HAMD)评分低于治疗前(P<0.05)、重复性成套神经心理状态测验(RBANS)评分高于治疗前(P<0.05),且联合组患者HAMD评分低于对照组(P<0.05),RBANS评分高于对照组(P<0.05);联合组患者血清γ-氨基丁酸(GABA)、5-羟色胺(5-HT)及多巴胺(DA)水平均高于对照组(P<0.05);治疗后,联合组治疗总有效率高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义。结论:度洛西汀联合重复经颅磁刺激能够提高重度抑郁症患者GABA、5-HT、DA等神经递质水平,改善认知功能。

Objective:To investigate the impacts of duloxetine combined with repetitive transcranial magnetic stimulation on neurotransmitter levels and cognitive function in patients with severe depression.Methods:A total of 200 patients with severe depression were randomly grouped into the control group and the combined group.The control group was treated with duloxetine hydrochloride enteric-coated capsules,and the combination group was treated with repeated transcranial magnetic stimulation on the basis of the control group.The curative effect and the cognitive function and neurotransmitter levels of the patients after treatment were compared between the two groups.Results:The total effective rate of combination group was higher than that of control group(P<0.05).The scores of Hamilton Depression Scale(HAMD)and repeatable battery for the asessment of neuropsychological status(RBANS)before and after treatment were significantly different between the two groups(P<0.05).After 6 weeks of treatment,HAMD scores in combination group were lower and RBANS scores were higher than those in control group(both P<0.05).The serum levels of gamma-aminobutyric acid(GABA),5-hydroxytryptamine(5-HT)and dopamine(DA)in combination group were higher than those in control group,and there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Duloxetine combined with repetitive transcranial magnetic stimulation can increase the levels of GABA,5-HT,DA and other neurotransmitters in patients with severe depression,and improve cognitive function.