草酸艾司西酞普兰联合重复经颅磁刺激对改善难治性抑郁症患者执行功能的疗效研究

目的探讨草酸艾司西酞普兰联合低频重复经颅磁刺激(rTMS)对难治性抑郁症患者执行功能康复的临床疗效。方法选取2013年12月-2015年6月在天津市精神卫生中心就诊的符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)难治性抑郁症诊断标准的门诊或住院患者68例,采用Excel 2010生成的随机序号进行分组,分为rTMS治疗组和假刺激组各34例,两组均服用草酸艾司西酞普兰治疗,治疗组联合rTMS治疗,假刺激组联合假刺激治疗,两组均治疗4周。治疗前后对两组进行数字广度测验(DST)和威斯康星卡片分类测验(WCST)。结果治疗4周后,rTMS组DST的正序评分及总评分均高于假刺激组(P0.05),rTMS组WCST总应答数、完成分类数、正确应答数均高于假刺激组,而错误应答数和持续错误数评分低于假刺激组,差异均有统计学意义(P0.05)。结论草酸艾斯西酞普兰联合rTMS对改善难治性抑郁症患者执行功能的效果优于单用草酸艾斯西酞普兰治疗。

Effects of repetitive transcranial magnetic stimulation combined with escitalopram oxalate on executive function in patients with treatment - resistant depression

Objective To explore the clinical efficacy of the combination of escitalopram oxalate and the repetitive transcranial magnetic stimulation(rTMS)on the rehabilitation of executive function in patients with treatment - resistant depression(TRD). Meth-ods A total of 68 patients(inpatients or outpatients)with TRD from Tianjin Mental Health Center(according to DSM - 4)in Dec. 2013 to Jun. 2015 were selected and divided into active rTMS group and sham rTMS group by the random numbers. All the patients were treated with escitalopram oxalate for 4 weeks,rTMS group and sham rTMS group were combined with active and sham rTMS,re-spectively. All the participants were assessed before and after treatment with the Digit Span Test(DST)and Wisconsin Card Sorting Test(WCST). Results After treatment,in rTMS group,the forward score and total score of DST were statistically significant compare to that in the sham rTMS group(P ﹤ 0. 05),and in WCST,the scores of RA(Responses Answer),CC(Categories Completed)and RC(Correct Responses)were higher,while RE(Errors Responses)and RPE(Perseverative Responses Errors)were lower than that in the sham group(P ﹤ 0. 05). Conclusion The active rTMS intervention combined with escitalopram can improve the executive func-tion of the patients with TRD.