中国临床康复2004，Vol.8Issue(9)：1770-1771,2.
重复经颅磁刺激治疗重型抑郁症的对照研究
A controlled study of the treatment of repetitive transcranial magnetic stimulation in patients with major depression
摘要
Abstract
BACKGROUND:High-frequency repetitive transcranial magnetic stimulation(rTMS) has been reported to produce antidepressant effects for exciting more horizontally connected neurons in cerebral cortex and subsequently increased focal metabolite,which are preferable to electro convulsive therapy(ECT) when taking into account safety and side-effect. OBJECTIVE:To assess the therapeutic effect of rTMS in treating major depression,and to explore its therapeutic mechanism. DESIGN:A clinical case control study. SETTING,PARTICIPANTS and INTERVENTION:Thirty-six patients,with major depression from affiliated hospital of Chunbei Medical College were divided into rTMS group(n=18) and ECT group(n=18) according to Randomized Drawing lots.Patients of two groups were assessed with Hamilton depression(HAMD) rating scale before and two weeks after treatment,meanwhile levels of plasm 5-HT and norepinephrine(NE) were also determined. MAIN OUTCOME MEASURES:Scores for HAMD,levels of 5-HT and NE,and side effects resulted from treatment were observed. RESULTS:Efficacy was 89%( 16/18) in rTMS group,remarkably different from that in ECT group( 83% ,15/18) (χ 2=0.812,P >0.05).Scores of HAMD were 11.6± 3.0 and 12.1± 2.9 respectively in rTMS and ECT group after treatment,and both were statistically lowered than those before treatment(27.8± 3.2 and 26.7± 2.8,t=2.891- 3.279,P< 0.05- 0.005). Plasma 5-HT increased from(2.45± 0.86)ng/L to(8.42± 1.65) ng/L due to rTMS treatment,and differences were remarkable( t=2.295, P< 0.05) . Side effects were observed in patients receiving ECT treatment,including obvious dizziness,fatigue,impaired memory and so on,while obvious discomfort could not observed in rTMS group,except individually transient mild headache. CONCLUSION:rTMS and ECT are promising on treating major medicine-resistant depression,but the former proved to be preferable with respect to safety and side effect.The therapeutic mechanism was hypothetically correlated with 5-HT releasing.关键词
抑郁障碍/治疗/磁力学/生物胺神经递质类分类
医药卫生引用本文复制引用
王晓明,杨德本,喻元凤,黄慧,赵小琼..重复经颅磁刺激治疗重型抑郁症的对照研究[J].中国临床康复,2004,8(9):1770-1771,2.基金项目
四川省教育厅科研资金资助项目 (1999川教计 164号 ) （1999川教计 164号 ）
四川省医学重点学科建设项目 (2002川卫 138号 ) （2002川卫 138号 ）
