重复经颅磁刺激联合氟西汀治疗老年抑郁症的临床对照研究.docVIP

精品论文 参考文献 重复经颅磁刺激联合氟西汀治疗老年抑郁症的临床对照研究 茅卫兵 江飞 朱圣洁 徐健 　　（南通市第四人民医院 江苏南通 226005） 　　【摘要】目的：探讨rTMS治疗老年抑郁症首次发病患者的有效性及安全性。方法：采用随机、单盲对照法，将63例年龄大于60岁的抑郁症首发患者分为rTMS组和氟西汀组，两组均服用氟西汀20mg/d，rTMS组加用6周rTMS真性刺激，以10Hz、90％运动阈值刺激患者左前额叶背外侧，氟西汀组加用6周rTMS伪刺激治疗。治疗前后用汉密顿抑郁量表(HAMD-17)和副反应量表(TESS)评价疗效和不良反应。结果：实际完成观察63例，其中rTMS组31例，氟西汀组32例。治疗第1周末，rTMS组的HAMD总分较治疗前明显下降（P﹤O.01），有效率及减分率均高于氟西汀组（P﹤O.05）。氟西汀组HAMD总分在治疗第2周末较治疗前明显下降（P﹤O.01）；治疗第1,2周末，rTMS组有效率高于氟西汀组???组间差异均有统计学意义（P﹤O.05）。治疗第4,6周末，rTMS组治愈率高于氟西汀组，组间差异均有统计学意义（P﹤O.05），而两组有效率的差异无统计学意义（Pgt;O.05）。两组患者出现药物不良反应者各4例，差异无统计学意义（Pgt;O.05）。结论：rTMS联合氟西汀治疗老年首发抑郁症患者起效较快、安全、疗效肯定,治愈率更高。 　　【关键词】抑郁症；老年人；氟西汀；重复经颅磁刺激 　　【中图分类号】R453 【文献标识码】A 【文章编号】1007-8231（2016）09-0037-03 　　 The efficacy and tolerabilityl of repetitive transeranial magnetic stimulation(rTMS) combined with fluoxetine in treatment of elderly patients with first-episode depression 　　 Mao Weibing,Jiang Fei,Zhu Shengjie,Xu Jian. The Forth Hospital of Nantong,Nantong 226005,China 　　【Abstract】Objective To study the efficacy and safety of repetitive transeranial magnetic stimulation(rTMS) combined with fluoxetine in treating the elderly patients with first-episode depression.Methods A random,single blind study was conducted in 63 first-episode depressive patients aged 60 years or over.The patients were assigned to fluoxetine treatment(20mg/d) in combination with a six-week period of either rTMS(rTMS group)or sham procedure(fluoxetine group) on left dorsolateral prefront cortex(10Hz,90% motor threshold).The efficacy was evaluated with the humilton rating scale for depression(HAMD). The safety profiles were assessed with TESS.Results 63 cases were finished the study.At the end of weeks 1 ,significantly more HAMD score reduction was in rTMS group than in fiuoxetine group.At weeks 1 and 2,the response rates in rTMS group were significantly higher than fluoxetine group(P﹤0.01).At weeks 4 and 6,the remission rates in rTMS group were significantly higher than fluo