重复经颅磁刺激治疗双相抑郁的研究

目的：探讨重复经颅磁刺激（rTMS）治疗双相抑郁（BDD）的疗效和安全性。方法：将BDD患者71例随机分为研究组36例和对照组35例；2组均服用拉莫三嗪治疗，研究组联合rTMS治疗，对照组给予假刺激治疗。结果：治疗2周后，2组汉密顿抑郁量表（HAMD）及临床总体印象一病情严重程度量表（CGISI）评分均较治疗前明显降低（P〈0．01），但2组间差异无统计学意义；治疗4周后，2组HAMD、CGI—SI评分均较治疗前及治疗2周后明显降低，且研究组更低于对照组（均P〈0．01）。研究组总有效率明显高于对照组（63．89％、25．71％，P〈0．01）。结论：rTMS可以更早地改善BDD患者的临床症状、有效地提高治疗BDD的有效率和缓解率，可作为治疗BDD的一种安全有效的辅助治疗方法。

Therapeutic effect of repetitive transcranial magnetic stimulation for bipolar depressive disorder

Objective：To assess the therapeutic effect of repetitive transcranial magnetic stimulation （rTMS） in the treatment of bipolar depressive disorder. Methods： All 71 patients with bipolar depressive disorder were randomly as signed to lamotrigine treatment in combination with rTMS （study group） or sham procedure （control group） on left dorsal-lateral prefrontal cortex. Results： After treatment of two weeks, the Hamilton depression scale-17 items （HAMD） and the clinical global impression-severity of illness （CGI-S1） total scores of both groups were significant ly improved （P〈0. 01）, but there was no significant difference between the two groups. After treatment of four weeks,the HAMD and CGI-SI total scores of both groups were significantly improved as compared with those before treatment and after treatment of two weeks,and more obviously in study group than in control group （all P〈0.01）. The response rate was significantly greater in study group than in control group after treatment （63. 89% vs. 25.71 % P〈0.01 ）. Conclusion：Augmentative rTMS was effective and well tolerated in bipolar depressive patients. It suggests that rTMS can be used as a good choice in the treatment of bipolar depressive disorder.