低频重复经颅磁刺激合并文拉法辛治疗难治性抑郁症的对照研究

目的探讨低频重复经颅磁刺激（rTMS）合并文拉法辛治疗难治性抑郁症（TRD）的疗效及安全性。方法 47例TRD患者随机分为研究组（n=24,rTMS合并文拉法辛）和对照组（n=23,单用文拉法辛）,研究组给予rTMS治疗每周5次,疗程6周。采用汉密尔顿抑郁量表（HAMD）评价疗效。结果研究组有效率为66.67%,对照组有效率为34.79%,组间比较差异有统计学意义（χ2=4.778,P〈0.05）。治疗2、4、6周研究组HAMD总分显著低于对照组（P〈0.05或P〈0.01）。组间不良反应发生率比较差异无统计学意义（χ2=0.038,P〉0.05）。结论低频rTMS合并文拉法辛治疗可显著改善TRD患者的抑郁症状,疗效优于单用文拉法辛治疗,且安全性较高。

A comparative study of slow repetitive transcranial magnetic stimulation combined with Venlafaxine in the treatment of treatment resistant depression

Objective To explore the efficacy and safety of slow repetitive transcranial magnetic stimulation(rTMS) combined with Venlafaxine in the treatment of treatment resistant depression(TRD).Methods Totally 47 cases of TRD patients were randomly divided into the study group(n = 24,rTMS combined with Venlafaxine therapy) and the control group(n = 23,Venlafaxine monotherapy).The study group was treated with slow rTMS 5 times each week,for 6 weeks.Hamilton depression scale(HAMD) was used to evaluate clinical efficacy.Results The effective rate of the study group was 66.67% and the control group was 34.79%,the difference was statistically significant(χ2 = 4.778,P < 0.05).The total scores of HAMD in the study group were much lower than those in the control group at 2,4 and 6 weeks after treatment(P < 0.05 or P < 0.01).There were no significant differences in incidence of adverse reactions between the two groups(χ2 = 0.038,P > 0.05).Conclusion Compared with Venlafaxine monotherapy,rTMS combined with Venlafaxine has been proven to improve the depressive symptoms significantly,which is safe without serious side effects.