无抽搐电休克治疗重性抑郁障碍临床研究

目的观察无抽搐电休克治疗（MECT）重性抑郁障碍的疗效及安全性。方法将63例重性抑郁障碍患者随机分成两组，分别采用MECT和西肽普兰药物治疗，观察期为6周。以汉密尔顿抑郁量表（HAMD）总分及减分率为主要临床疗效评价指标；以抑郁自评量表（SDS）、焦虑自评量表（SAS）、汉密尔顿焦虑量表（HAMA）总分的差异为次要疗效评估指标；以治疗时出现的症状量表（TESS）观察治疗出现的不良反应；并采用临床记忆量表观察观察组患者的记忆变化。结果治疗第6周末，观察组的临床痊愈率和有效率明显高于对照组（P〈0.05或0．01）。观察组SAS总粗分、SDS总粗分、HAMA总分、HAMD总分治疗第1周末即较治疗前下降（P〈0.05或0．01），而对照组于治疗第2周末才开始下降（P〈0．05）；观察期内，观察组除SAS总粗分仅于治疗后1周末、2周末显著低于对照组（均P〈0.01）外，上述其它量表分治疗后各时点均低于对照组（P〈0．05或0．01）。两组间治疗后各时点TESS总分比较无统计学意义。观察组临床记忆量表治疗后第一个24h时指向记忆、图象自由回忆、无意义图形再认分值较治疗前下降（均P〈0．05），治疗后6周末各项量表分值及记忆商值较治疗前升高（P〈0．05或0.01）。结论MECT对重性抑郁障碍起效较迅速，疗效较显著，安全性较好。

Efficacy of modified electroconvulsive therapy(MECT)in treatment of major depressive episode

Objective To evaluate the efficacy and safety of modified electroconvulsive therapy （MECT） in treatment of major depressive episode. Methods Sixty three patients diagnosed as major depressive episode were randomly divided into two groups; patients in each group received MECT （MECT group） or citalopram therapy （control group）. Patients were followed up for 6 weeks and the efficacy and safety were evaluated by the Hamilton Rating Scale for Depression （HAMD）, Self-Rating Depression Scale （SDS）, Self-Rating Anxiety Scale （SAS）, Hamilton Rating Scale for Anxiety （HAMA）, Treatment Emergent Symptom Scale （TESS） and Clinical Memory Scale before and week 1-6 after therapy. Results There were significant differences in the recovery rates and the response rates between two groups at the end of week 6 （P〈0.05 or P〈0.01）. SAS scores, SDS scores, HAMD scores and HAMA scores decreased 1 week after treatment in MECT group, while control group showed no significant difference. The decrease of SDS, HAMD and HAMA scores in MECT group were more markedly than that of control group at the end of week 1-6. TESS scores did not differ between two groups. Directing memory, image free recollection, the insignificant graph recognizes again of Clinical Memory Scale in MECT group were decrease 24h after treatment （P〈0.05）, the scale scores and memory scores were increased significantly at the end of week 6 （P〈0.05 or P〈0.01）. Conclusion MECT is effective in treatment of major depression episode with safety.