经颅微电流刺激联合本森放松技术在首发抑郁症患者中的临床应用

Clinical application of cranial electrotherapy stimulation combined with Benson's relaxation technique in patients with first-episode depression

目的探讨经颅微电流刺激(CES)联合本森放松技术(BRT)对首发抑郁症患者神经递质、抑郁及躯体化症状的调控作用。方法选取2022年6月至2023年3月郑州大学第一附属医院精神医学科收治的108例首发抑郁症患者纳入研究,按随机数表法分为观察组、对照1组和对照2组,每组36例。所有患者均采取常规药物治疗,于此基础上对照1组采取CES治疗,对照2组采取BRT治疗,观察组患者采取CES联合BRT治疗,连续治疗8周。比较三组患者治疗前、治疗4周、8周后的神经递质[5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)]水平、重复性成套神经心理状态测试(RBANS)、汉密尔顿抑郁量表(HAMD)、自杀意念量表(BSI-CV)及躯体症状群量表(PHQ-15)评分。结果治疗前,三组患者的神经递质水平比较差异均无统计学意义(P>0.05);治疗4周、8周后,三组患者的神经递质水平呈逐渐升高趋势,且治疗4周、8周后,观察组患者的血清5-HT、DA、NE水平>对照1组>对照2组,差异均有统计学意义(P<0.05)。治疗前和治疗4周后,三组患者的认知功能水平比较差异均无统计学意义(P>0.05);治疗4周、8周后,三组患者的认知功能评分呈逐渐升高趋势,且治疗8周后,观察组患者的认知功能评分>对照1组>对照2组,差异均有统计学意义(P<0.05)。治疗前,三组患者的HAMD、BSI-CV评分比较差异均无统计学意义(P>0.05);治疗4周、8周后,三组患者的HAMD、BSI-CV评分呈逐渐降低趋势,且治疗4周、8周后,观察组患者的HAMD、BSI-CV评分<对照2组<对照1组,差异均有统计学意义(P<0.05)。治疗前,三组患者的PHQ-15评分比较差异均无统计学意义(P>0.05);治疗4周、8周后,三组患者的PHQ-15评分呈逐渐降低趋势,且治疗4周、8周后,观察组患者的PHQ-15评分低于对照1组和对照2组,差异均有统计学意义(P<0.05),但对照1组和对照2组间比较差异均无统计学意义(P>0.05)。结论CES联合BRT应用于首发抑郁症患者可发挥协同作用,有助于改善患者神经递质水平,减轻抑郁及躯体化症状,降低自杀意念。

Objective To investigate the regulatory effect of cranial electrotherapy stimulation(CES)com-bined with Benson's relaxation technique(BRT)on neurotransmitters,depression,and somatic symptoms in patients with first-episode depression.Methods A total of 108 patients with first-episode depression admitted to the Depart-ment of Psychiatry,the First Affiliated Hospital of Zhengzhou University from June 2022 to March 2023 were select-ed for inclusion in the study.They were randomly divided into an observation group,a control group 1,and a control group 2,with 36 patients in each group.All patients received conventional drug treatment.On this basis,the control group 1 received CES treatment,the control group 2 received BRT treatment,and the observation group received CES combined with BRT treatment,continuously for 8 weeks.The levels of neurotransmitters[5-hydroxytryptamine(5-HT),dopamine(DA),noradrenaline(NE)],the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),the Hamilton Depression Scale(HAMD),Beck Scale for Suicide Ideation-Chinese Version(BSI-CV),and the Patient Health Questionnaire(PHQ-15)scores before treatment,after 4 weeks treatment,and after 8 weeks of treat-ment were compared among the three groups.Results Before treatment,there was no significant difference in neu-rotransmitter levels among the three groups(P>0.05).After 4 and 8 weeks of treatment,the levels of neurotransmitters in the three groups showed a gradually increasing trend,and after 4 and 8 weeks of treatment,the levels of serum 5-HT,DA,and NE in the observation group were significantly higher than those in the control group 1 and control group 2,and the differences were statistically significant(P<0.05).Before treatment and after 4 weeks of treatment,there was no sig-nificant difference in the level of cognitive function among the three groups(P>0.05).After 4 weeks and 8 weeks of treatment,the cognitive function scores of the three groups showed a gradual increasing trend,and after 8 weeks of treat-ment,the cognitive function scores decreased successively in the observation group,the control group 1,and control group 2(P<0.05).Before treatment,there was no significant difference in HAMD and BSI-CV scores among the three groups(P>0.05).After 4 weeks and 8 weeks of treatment,the HAMD and BSI-CV scores of the three groups showed a decreasing trend,and after 4 weeks and 8 weeks of treatment,the HAMD and BSI-CV scores increased successively in the observation group,the control group 2,and the control group 1(P<0.05).Before treatment,there was no significant difference in PHQ-15 score among the three groups(P>0.05).After 4 and 8 weeks of treatment,the PHQ-15 scores of the three groups gradually decreased,and after 4 weeks and 8 weeks of treatment,the PHQ-15 scores of the observation group were lower than those of the control group 1 and the control group 2(P<0.05),with no statistically significant dif-ference between the control group 1 and the control group 2(P>0.05).Conclusion The application of CES combined with BRT in patients with first-episode depression can play a synergistic role,help to improve the level of neurotransmit-ters in patients,reduce depression and somatization symptoms,and reduce suicidal ideation.