艾司西酞普兰联合虚拟现实认知行为疗法治疗抑郁症的临床观察

目的 探讨在应用常规药物基础上，联合基于虚拟现实技术的认知行为疗法（VR-CBT）治疗抑郁症的临床效果。方法 选取2019 年5 月至2020 年5 月我院诊治的159 例抑郁症患者，按随机数字表法分为艾司西酞普兰（ES）组、认知行为疗法（CBT）组和VR-CBT 组，各53 例。ES 组给予ES 口服，每日1 次，CBT 组在ES 组基础上给予CBT 治疗，每次1 h，每周3 次，VR-CBT 组在ES 组基础上给予VR-CBT 治疗，每次1 h，每周3 次。各组均连续治疗3 个月。治疗前后，各组患者均接受17 项汉密尔顿抑郁量表（HAMD）、抑郁自评量表（SDS）评定抑郁程度，并以HAMD 评分下降幅度作为疗效判定标准，接受威斯康辛卡片分类测验（WCST）、数字符号转换测试（DSST）评定认知功能。治疗期间，接受副反应量表（TESS）评定治疗安全性。结果 CBT 组治疗后总有效率为82.35%，VRCBT 组总有效率为92.31%，均高于ES 组的67.31%，且VR-CBT 组总有效率高于CBT 组，差异有统计学意义（P<0.05）；各组治疗后HAMD、SDS 评分均低于治疗前，且CBT、VR-CBT 组均低于ES 组，VR-CBT 组均低于CBT 组，差异有统计学意义（P<0.05）；各组治疗后WCST 正确应答数百分比、DSST 评分均高于治疗前，且CBT、VR-CBT组均高于ES 组，VR-CBT 组均高于CBT 组，差异有统计学意义（P<0.05）；治疗期间，各组TESS 评分各时间点比较，差异均无统计学意义（P>0.05）。结论 ES 联合VR-CBT 治疗抑郁症效果显著，明显优于联合传统CBT 疗法，能显著降低患者抑郁程度，提高认知功能，安全性较好，值得临床推广应用。

Clinical observation of escitalopram combined with virtual reality cognitive behavioral therapy in treatment of depression

Objective To investigate the clinical effect of cognitive behavioral therapy based on virtual reality (VR-CBT)combined with conventional drugs in the treatment of depression.Methods A total of 159 patients with depression diagnosed and treated in our hospital from May 2019 to May 2020 were divided into the escitalopram(ES) group,the cognitive behavioral therapy(CBT) group and the VR-CBT group according to the random number table method,with 53 patients in each group.The ES group was given ES orally,once a day;the CBT group was given CBT for 1 hour each time,3 times a week,on the basis of the ES group;the VR-CBT group was given VR-CBT for 1 hour each time,3 times a week,on the basis of the ES group.All the 3 groups were treated for 3 months continuously.Before and after treatment,each group was given 17 items of Hamilton Depression Scale (HAMD) and Self-rating Depression Scale (SDS) to assess the degree of depression,and the reduction of HAMD score was used as the criterion of efficacy,and the cognitive function was assessed by Wisconsin Card Sorting Test (WCST) and Number Sign Conversion Test (DSST).During treatment,treatment safety was assessed by Treatment Emergent Symptom Scale (TESS).Results After treatment,the total effective rates of the CBT group (82.35%) and the VR-CBT group (92.31%) were higher than that of the ES group(67.31%),and that of the VR-CBT group was higher than that of the CBT group,the difference was statistically significant(P<0.05).After treatment,the HAMD and SDS scores of all groups were lower than those before treatment,and the scores of the CBT and VR-CBT groups were lower than those of the ES group,and those of the VR-CBT group were lower than those of the CBT group,the difference was statistically significant(P<0.05).After treatment,the percentage of WCST correct response and the DSST score in all groups were higher than those before treatment,and those of the CBT and VR-CBT groups were higher than those of the ES group,and those of the VR-CBT group were higher than those of the CBT group,the difference was statistically significant(P<0.05).During treatment,no statistically significant differences were observed in TESS scores at each time point in each group (P>0.05).Conclusion The combination of ES and VRCBT in the treatment of depression has a significant effect,which is significantly better than the combination of ER and traditional CBT.It can significantly reduce the depression degree of patients,improve cognitive function,and has a good safety,which is worthy of clinical promotion and application.