经颅磁刺激联合氟西汀对轻中度抑郁症伴失眠患者的效果

The value of transcranial magnetic stimulation combined with fluoxetine in mild to moderate depression patients with insomnia

目的探讨经颅磁刺激联合氟西汀在轻中度抑郁症伴失眠患者中的应用价值。方法选择我院2020年1月~2022年1月收治的100例轻中度抑郁症伴失眠患者进行研究,采用随机数字表通过简单随机方法将入组患者分为研究组与对照组每组50例,对照组接受氟西汀治疗,研究组接受经颅磁刺激联合氟西汀治疗,经过6周的治疗,比较两组患者治疗前后汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分、睡眠时长、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)、脑脊液5-羟色胺(hydroxytryptamine,5-HT)水平以及不良反应发生情况。结果治疗前,两组组间各项观察指标比较,差异均无统计学意义(P>0.05);治疗后,研究组HAMD评分、PSQI评分均低于对照组,而睡眠时长、脑脊液5-HT水平均高于对照组,差异均具有统计学意义(P<0.05)。两组治疗过程中不良反应程度均较轻,且随着治疗的推进,经观察均可自行缓解,无须特别处理,研究组与对照组不良反应发生率分别为22.00%和14.00%,差异无统计学意义(P>0.05)。结论经颅磁刺激联合氟西汀治疗轻中度抑郁症伴失眠患者疗效明显,在缓解患者抑郁状态和改善睡眠质量方面均表现出较大的优势,且具有较高的安全性,适合推广应用。

Objective To investigate the application value of transcranial magnetic stimulation combined with fluoxetine in patients with mild to moderate depression and insomnia.Methods A total of 100 patients with mild to moderate depression and insomnia who were admitted to our hospital from January 2020 to January 2022 were selected for the study,and the enrolled patients were divided into a study group and a control group by a simple random method using a random number table,50 cases in each group.The control group received fluoxetine treatment,and the research group received transcranial magnetic stimulation combined with fluoxetine treatment.After 6 weeks of treatment,the Hamilton Depression Scale(HAMD)score,sleep duration,and Pitsburgh Sleep Quality Index(PSQI),the 5-HT levle in cerebrospinal fluid,and occurrence of adverse reactions were compared between the two groups before and after treatment.Results Before treatment,there was no significant difference in various observation indicators between the two groups(P>0.05).After treatment,the HAMD score and PSQI score of the study group were lower than those of the control group,while the sleep time was longer than that in the control group and the 5-HT levle in cerebrospinal fluid was higher in the study group than that in the control group,and the difference was statistically significant(P<0.05).The adverse reactions in the two groups were mild,and with the progress of the treatment,they were all relieved by observation,and no special treatment was required.The incidence of adverse reactions in the study group and control group were 22.00%and 14.00%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Transcranial magnetic stimulation combined with fluoxetine has obvious curative effect in the treatment of patients with mild to moderate depression and insomnia.It shows great advantages in relieving patients'depression and improving sleep quality.It has high safety and is suitable for popularization and application.