重复经颅磁刺激联合文拉法辛治疗产后抑郁症的对照研究

目的:观察重复经颅磁刺激(rTMS)联合文拉法辛缓释片治疗产后抑郁症的疗效和安全性及其副作用。方法:将58例产后抑郁症患者随机分为治疗组30例和对照组28例。两组均给予文拉法辛缓释片75 mg/d顿服,疗程4周。治疗组在此基础上应用重复经颅磁刺激治疗,以30%刺激强度刺激患者左额叶背外侧,频率为10 Hz,每日1次,连续治疗5点为1个疗程,疗程之间间隔2天,连续治疗4个疗程。治疗前和治疗后1、2、4周末采用HAMD量表评定抑郁症状,采用TESS量表评定副反应。结果:58例患者均完成治疗,两组HAMD评分在治疗2周末与治疗前比较差异均有统计学意义(P<0.05或P<0.01),治疗组在治疗第1周末即显示明显疗效(P<0.01)。治疗组有效率高于对照组(P<0.05)。两组均未观察到明显的副反应。结论:重复经颅磁刺激联合文拉法辛治疗产后抑郁症疗效显著,安全性好,可以提高疗效。

The association study of treating postpartum depression by repetitive transcranial magnetic stimulation combined with venlafaxine.

Objective:To explore the therapeutic effect and safety of treating postpartum depression by repetitive transcranial magnetic stimulation combined with venlafaxine. Methods:Fifty-eight cases of postpartum depression were randomly divided into treatment group(30 cases) and control group(28 cases).Two groups were given venlafaxine extended release tablets 75 mg/d for four weeks.On the same time,the treatment group applied repetitive transcranial magnetic stimulation treatment,30% stimulation intensity,frequency of 10Hz stimulation in patients with left dorsolateral frontal lobe,once a day,5 days for a course,2 days interval between treatment for 4 courses.HAMD rating scale were used to evaluate depression symptoms before and after treatment with 1,2,4 weekend.TESS rating scale were used to evaluate side effects. Results:Fifty-eight patients were completed the treatment.There were significantly different in HAMD scores between the treatment of the 2 weeks and before treatment(P<0.05 or P<0.01).Treatment group showed significant effect on the first weekend(P<0.01).The effectiveness in treatment group was higher than control groups(P<0.05).The significant side effects were not observed in the two groups. Conclusion:Repetitive transcranial magnetic stimulation combined with venlafaxine has significantly effect,safety,and can improve therapeutic effect in the treatment of postpartum depression.