高频重复经颅磁刺激联合舍曲林治疗对青少年抑郁症负性情绪的影响

Effect of high-frequency repetitive transcranial magnetic stimulation combined with sertraline therapy on the negative emotion in adolescent depressive disorder

目的 观察高频重复经颅磁刺激(rTMS)联合舍曲林治疗对青少年抑郁症负性情绪的影响。方法 回顾性选取2022年4月—2023年3月玉环市第二人民医院心理卫生科门诊或住院的青少年抑郁症60例,将其分为联合组和舍曲林组,每组30例。在基础抗抑郁治疗上,舍曲林组予以舍曲林治疗,联合组在舍曲林组基础上加用高频rTMS,2组均持续治疗8周。比较2组患儿临床疗效,治疗前与治疗2、4、6、8周时负性情绪、社会功能评分。结果 联合组与舍曲林组总有效率比较差异无统计学意义(93.33%vs. 80.00%,χ^(2)=1.298,P=0.255)。治疗2、4、6、8周时,2组24项汉密尔顿抑郁量表(HAMD-24)、抑郁自评量表(SDS)评分较治疗前逐渐降低,个人与社会功能量表(PSP)评分较治疗前逐渐升高(P<0.05或P<0.01);但治疗2周时,2组HAMD-24、SDS、PSP评分比较差异无统计学意义(P>0.05),联合组治疗4、6、8周时HAMD-24、SDS评分低于舍曲林组,PSP评分高于舍曲林组(P<0.05或P<0.01)。结论 高频rTMS联合舍曲林治疗青少年抑郁症疗效较佳,可缓解患儿负性情绪,提高患儿社会功能。

Objective To observe the effect of high-frequency rTMS combined with sertraline therapy on the negative emotions in adolescent depressive disorder.Methods A total of 60 cases of children with adolescent depressive disorder who were outpatients or hospitalized in the Mental Health Department of Yuhuan Second People′s Hospital from April 2022 to March 2023 were retrospectively selected and divided into the combined group and the sertraline group,with 30 cases in each group.The sertraline group was treated with sertraline on the basic treatment,and the combined group was treated with high-frequency rTMS on the basis of the sertraline group.The two groups were continued treated for 8 weeks.The clinical efficacy,the scores of negative emotion and social function before treatment and at 2,4,6 and 8 weeks of treatment between the two groups were compared.Results There was no significant difference in the total effective rate between the combined group and sertraline group(93.33%vs.80.00%,χ^(2)=1.298,P=0.255).At 2,4,6 and 8 weeks of treatment,the HAMD-24 and SDS scores gradually decreased,and the PSP score gradually increased of the two groups compared with those before treatment(P<0.05 or P<0.01).At 2 weeks of treatment,there was no statistically significant difference in the HAMD-24,SDS or PSP scores between the two groups(P>0.05).At 4,6 and 8 weeks of treatment,the HAMD-24 and SDS scores in the combined group were lower than those in the sertraline group,PSP score in the combined group was higher than that in the sertraline group(P<0.05 or P<0.01).Conclusion High-frequency rTMS combined with sertraline therapy have better efficacy in the treatment of adolescent depressive disorder,which can alleviate children′s negative emotion and improve their social function.