重复经颅磁刺激联合碳酸锂与喹硫平治疗双相情感障碍抑郁发作患者的效果

Repetitive transcranial magnetic stimulation combined with lithium carbonate and quetiapine in the treatment of patients with depressive episode of bipolar disorder

目的探究重复经颅磁刺激(rTMS)联合碳酸锂与喹硫平治疗双相情感障碍抑郁发作患者的效果。方法回顾性选取2021年1月—2023年7月上饶市第三人民医院心境障碍科收治的双相情感障碍抑郁发作患者100例,根据治疗方法不同分为常规组和联合rTMS组,各50例。常规组患者采用碳酸锂、喹硫平治疗,联合rTMS组患者在常规组基础上联合rTMS治疗。2组均以2周为1个疗程,共干预2个疗程。比较2组临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)评分及不良反应。结果联合rTMS组总有效率为96.00%,高于常规组的70.00%(χ^(2)=11.977,P=0.001)。治疗2个疗程后,2组NIHSS、SDS、PSQI评分降低,且联合rTMS组低于常规组(P<0.01)。联合rTMS组不良反应总发生率为4.00%,低于常规组的26.00%(χ^(2)=9.490,P=0.002)。结论双相情感障碍抑郁发作患者采用rTMS联合碳酸锂与喹硫平治疗可提升疗效,减轻神经功能缺损程度,缓解抑郁情绪,提高患者的生活质量,且有助于减少不良反应发生。

Objective To explore the clinical effect of rTMS combined with lithium carbonate and quetiapine in the treatment of patients with depressive episode of bipolar disorder.Methods A total of 100 patients with depressive episode of bipolar disorder admitted to the Department of Mood Disorders Unit,Shangrao Third People′s Hospital from January 2021 to July 2023 were retrospectively selected,and they were divided into the conventional group and the combined rTMS group according to the different treatment,with 50 patients in each group.Patients in the conventional group were treated with lithium carbonate and quetiapine,while patients in the combined rTMS group were treated with rTMS on the basis of the conventional group.Both groups were taken 2 weeks as 1 course of treatment,and a total of 2 courses of intervention were performed.Clinical efficacy,scores of NIHSS,SDS,PSQI before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate in the combined rTMS group was 96.00%,which was higher than 70.00%in the conventional group(χ^(2)=11.977,P=0.001).After 2 courses of treatment,scores of NIHSS,SDS and PSQI decreased in the two groups,and the combined rTMS group were lower than those in the conventional group(P<0.01).The total incidence of adverse reactions in the combined rTMS group was 4.00%,which was lower than 26.00%in the conventional group(χ^(2)=9.490,P=0.002).Conclusion The use of rTMS combined with lithium carbonate and quetiapine can enhance the efficacy in the treatment of patients with depressive episode of bipolar disorder,it can reduce the degree of neurological deficits,alleviate depression,improve the quality of life of patients,and help to reduce the occurrence of adverse reactions.