低频经颅磁刺激联合拉莫三嗪治疗强迫症的临床效果

Clinical efficacy of low-frequency transcranial magnetic stimulation combined with lamotrigine in the treatment of obsessive-compulsive disorder

目的:观察低频经颅磁刺激(transcranial magnetic stimulation, TMS)技术联合拉莫三嗪治疗强迫症(obsessive-compulsive disorder, OCD)的效果。方法:选取128例OCD患者,采用计算机随机分组法将其分为观察组和对照组,每组64例。对照组予以拉莫三嗪及常规药物治疗,观察组采用低频TMS结合拉莫三嗪治疗。比较两组治疗后的神经递质水平、白细胞介素-6(IL-6)水平、耶鲁布朗强迫量表(Y-BOCS)评分及治疗的安全性。结果:治疗后,观察组5-羟色胺(5-HT)水平高于对照组,多巴胺(DA)、谷氨酸(Glu)水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗3 d、7 d、14 d后的IL-6水平、Y-BOCS评分均低于对照组(P<0.05)。观察组与对照组的不良事件发生率比较,差异无统计学意义(P>0.05)。结论:低频TMS联合拉莫三嗪治疗OCD能有效改善神经递质水平,降低IL-6水平,促进强迫症患者康复。

Objective:To observe the efficacy and safety of low-frequency transcranial magnetic stimulation(TMS)combined with lamotrigine in the treatment of obsessive-compulsive disorder(OCD).Methods:128 patients with OCD were selected and randomly divided into the observation group and control group using computer randomization,with 64 cases in each group.The control group were treated with lamotrigine and conventional drugs,while the observation group were treated with low-frequency TMS combined with lamotrigine.The levels of neurotransmitters,interleukin-6(IL-6),Yale Brown Compulsive Scale(Y-BOCS)scores,and treatment safety of the two groups of patients were compared after treatment.Results:After treatment,the 5-hydroxytryptamine(5-HT)in the observation group was higher than that in the control group,while the levels of dopamine(DA)and glutamate(Glu)were lower than those in the control group,with statistically significant differences(P<0.05).The IL-6 level,and Y-BOCS score of the observation group after 3,7,and 14 d of treatment were lower than those of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse events between the observation group and the control group(P>0.05).Conclusion:The combination of low-frequency TMS and lamotrigine in the treatment of OCD can effectively improve neurotransmitter levels,reduce IL-6 levels,and promote the recovery of patients with obsessive-compulsive disorder.