氟西汀联合重复经颅磁刺激治疗对抑郁症患者疗效及认知功能的影响

目的：探讨氟西汀联合重复经颅磁刺激治疗对抑郁症患者疗效及认知功能的影响。方法将60例抑郁症患者随机分两组，每组30例。研究组口服氟西汀联合重复经颅磁刺激治疗，对照组口服氟西汀联合假经颅磁刺激治疗，观察6周。于治疗前后采用汉密顿抑郁量表评定临床疗效，威斯康星卡片分类测验评估认知功能，副反应量表评定不良反应。结果治疗第2周末研究组有效率显著高于对照组（P＜0．01），治疗第4周、6周末两组比较差异无显著性（P＞0．05）。治疗后研究组威斯康星卡片分类测验的正确反应数及完成分类数均较治疗前显著升高（P＜0．01），且研究组显著高于对照组（P＜0．05）；两组汉密顿抑郁量表评分较治疗前显著降低（P＜0．01），治疗第2周、4周末研究组显著低于对照组（P＜0．05）。治疗过程中，两组均未出现严重不良反应。结论氟西汀联合重复经颅磁刺激治疗抑郁症疗效显著，起效快，安全性高，且能显著改善患者的认知功能，优于单用氟西汀治疗。

Influences of fluoxetine plus rTMS on efficacy and cognitive function of depression patient

Objective To explore the influences of fluoxetine plus rTMS on efficacy and cognitive function of depression patient .Methods Sixty depression patients were randomly divided into two groups of 30 ones each ,both groups took orally fluoxetine ,research group was plus repetitive transcranial magnetic stimulation （rTMS） and control group plus pseudo-TMS for 6 weeks .Clinical efficacies were assessed with the Hamilton Depression Scale （HAMD ） , cognitive functions with the Wisconsin Card Sorting Test （WCST） ,and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before and after treatment .Results At the end of the 2^nd week effective rate was significantly higher in research than con-trol group （P〈0 .01） ,there were no significant group differences at the end of the 4th and 6th week （P〉0 .05） .Correct responses and the number of achieved categories heightened more significantly in research group after treatment compared with pre-treatment （P〉0 .01） ,so did those in research than control group （P〈0 .05）;the HAMD scores of both groups lowered more significantly after treatment compared with pre-treatment （P〈0 .01） ,so did those in research than control group at the end of the 2^nd and 4^th week （P〈0 .05） .Both groups had no severe adverse reactions during treatment .Conclusion Fluoxetine plus rTMS has an evident effect ,takes effect more rapidly ,has higher safety ,and could notably improve patients’ cognitive function compared with fluoxetine monotherapy for depression .