rTMS联合认知行为疗法对儿童青少年强迫症的效果分析

Effect of rTMS combined with cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorder

目的 探讨重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)联合认知行为疗法(Cognitive behavioral therapy,CBT)对儿童青少年强迫症(Obsessive compulsive disorder,OCD)的干预价值。方法 选取2020年8月~2023年8月本院门诊患者中患有强迫症的儿童青少年150例,随机数字表法分为研究组和对照组,各75例。两组患儿均给予曲舍林口服,对照组患儿实施CBT干预,在此基础上研究组实施rTMS干预。比较两组患儿临床疗效以及强迫症状[采用耶鲁-布朗强迫症量表(Yale Brown Obsessive Compulsive Scale,Y-BOCS)评估]、焦虑症状[采用汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评估]、认知功能[采用蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)]和生活质量[采用WHO生活质量测定量表(WHO Quality of Life Scale,WHOQOL-BREF)评估]等改善情况。结果 研究组患儿总有效率高于对照组(P<0.05)。干预6周末,研究组患儿Y-BOCS评分、HAMA评分均低于对照组(P<0.05)。干预6周末,研究组患儿MoCA和WHOQOL-BREF各维度评分均高于对照组(P<0.05)。结论 rTMS联合CBT能够有效改善儿童青少年OCD患儿强迫、焦虑症状,提高其认知功能。

Objective To exploring the intervention value of repetitive transcranial magnetic stimulation(rTMS) combined with cognitive-behavioral therapy(CBT)in children and adolescents with obsessive-compulsive disorder(OCD).Methods 150 children and adolescents with obsessive-compulsive disorder admitted to our hospital from August 2020 to August 2023 were randomly divided into a study group and a control group,with 75 cases in each group,using a random number table method.Both groups of children were given oral trasylin,while the control group received CBT intervention.On this basis,the study group received rTMS intervention.Compare the clinical efficacy and improvement of obsessive-compulsive symptoms(evaluated using the Yale Brown Obsessive Disorder Scale(YBOCS)),anxiety symptoms(evaluated using the Hamilton Anxiety Scale(HAMA)),cognitive function(evaluated using the Montreal Cognitive Assessment Scale(MoCA)),and quality of life(evaluated using the WHO Quality of Life Scale(WHOQOL-BREF))between two groups of children.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After 6 weekends of intervention,the Y-BOCS score and HAMA score of the study group were lower than those of the control group(P<0.05).After 6 weekends of intervention,the MoCA and WHOQOL-BREF scores of the study group were higher than those of the control group in all dimensions(P<0.05).Conclusion The combination of rTMs and CBT can effectively improve the symptoms of compulsion and anxiety in children and adolescents with OCD,and enhance their cognitive function.