重复经颅磁刺激和无抽搐电痉挛治疗抑郁症的初步比较

目的探讨重复经颅磁刺激和无抽搐电痉挛治疗抗抑郁疗效的差异。方法纳入分别接受重复经颅磁刺激治疗(rTMS组)和无抽搐电痉挛治疗(MECT组)的难治性抑郁症患者各30例,采用汉密尔顿抑郁量表在治疗前和治疗结束时评估患者临床症状,比较两组患者的疗效差异。结果 rTMS和MECT均能显著改善患者抑郁症状(rTMS组:t=0.34,P=0.02;MECT组:t=0.23,P=0.00)。rTMS组在汉密尔顿量表睡眠障碍因子分改善方面显著高于MECT组,差异有显著统计学意义(t=7.88,P=0.01),MECT在改善自杀因子方面优于rTMS,差异有显著统计学意义(t=3.87,P=0.00)。结论 rTMS和ECT在短期内均能有效改善抑郁症状,MECT的抗抑郁作用强于rTMS。在改善睡眠障碍方面,rTMS优于MECT;在改善自杀因子方面,MECT组作用更强。

The Effect of Repetitive Transcranial Magnetic Stimulation versus Electroconvulsive Therapy on Depression

Objective To compare the difference of efficacy of rTMS and MECT in the treatment of depression .Methods Retrospective study was used to analyze the antidepressant effects of ECT and rTMS in 60 patients with MDD diagnosed according to ICD -10. Hamilton Depression Rating Scale were used to measure depressive symptom .Results Both ECT and rTMS significantly improved de-pression.There was significant difference between HAMD score of pretreatment and posttreatment （rTMS：t=0.34,P=0.02;MECT：t=0.23,P=0.00）.rTMS reduced significantly insomnia scores more than MECT （t=7.88,P=0.01）.MECT reduced significantly depression and suicidal scores more than rTMS （t=3.87,P=0.00）.Conclusion Both MECT and rTMS can improve MDD in the short term , but the antidepressant efficacy of MECT is greater than that of rTMS .MECT can lead to greater reductions in suicidal than rTMS ,but rTMS can lead to greater reductions in insomnia than MECT .