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重复经颅磁刺激与改良电休克治疗首发抑郁症起效时间的随机对照试验

李凝 王学义 李小倩 余明

中国心理卫生杂志Issue(9):667-671,5.
中国心理卫生杂志Issue(9):667-671,5.DOI:10.3969/j.issn.1000-6729.2015.09.006

重复经颅磁刺激与改良电休克治疗首发抑郁症起效时间的随机对照试验

A randomize controlled trial of early response between repetitive transcranial magnetic stimulation and modified electroconvulsive therapy in patients with first-episode depression

李凝 1王学义 1李小倩 1余明1

作者信息

  • 1. 河北医科大学第一医院精神卫生科,河北医科大学精神卫生研究所,河北省脑老化与认知神经科学重点实验室,石家庄050031
  • 折叠

摘要

Abstract

Objective:To explore the differences of the early response time between transcranial magnetic stimulation (rTMS ) and modified electroconvulsive therapy (MECT )in patients with first-episode depression.Methods:Totally 65 first-episode patients aged 18 -45 year were enrolled in the study.The diagnoses were made according tothe Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)criteria for depression.The patients randomly received rTMS(n =33)or MECT (n =32).All patients received co-therapy of escitalopram (10 -20 mg /day).Stimulation (20 Hz)was performed five times a week for four weeks and,a total of 20 consecutive working days over the left dorsolateral prefrontal cortex(DLPFC).MECT group received MECT treatment 3 times a week for 3 weeks,a total of eight times.The Hamilton Depression Rating Scale-24 items (HAMD)was used to assess the severity of clinical symptoms and reduction rates.Results:Compared with the pa-tients in MECT group,the patients in rTMS group showed a less reduction rates [(25.0.±3.1),(34.4 ±7.7), (52.2 ±7.8),(69.1 ±8.3),vs(28.2 ±5.4),(38.8 ±5.1 ),(57.7 ±6.8),(75.4 ±8.6),Ps <0.05]in the first four weeks and the suicidal behavior scores reduced less in rTMS group in the first two weeks (P <0.05).Conclu-sion:It suggests that both rTMS at 20 Hz and MECT combined with escitalopram could improve the first-episode depression within a week.While the efficacy of rTMS combined with escitaloprm slightly less than MECT com-bined with essitaloprm in rapid response and reducing the suicide risk of acut period.

关键词

重复经颅磁刺激/改良电休克治疗/艾司西酞普兰/首发抑郁症/随机对照试验

Key words

repetitive transcranial magnetic stimulation/modified electroconvulsive therapy/escitalopram/first-episode depression/randomize controlled trial

分类

医药卫生

引用本文复制引用

李凝,王学义,李小倩,余明..重复经颅磁刺激与改良电休克治疗首发抑郁症起效时间的随机对照试验[J].中国心理卫生杂志,2015,(9):667-671,5.

基金项目

河北省医学科学研究重点项目(20100256);河北省科技支撑计划重大项目 ()

中国心理卫生杂志

OA北大核心CHSSCDCSCDCSSCICSTPCD

1000-6729

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