重复经颅磁刺激与消郁汤辅助治疗首发抑郁症的临床对照研究

目的 探讨重复经颅磁刺激（r TMS）与中药消郁汤辅助治疗首发抑郁症的临床疗效和安全性。方法 139例首发抑郁症患者随机分为文拉法辛合并r TMS（研究组A）治疗40例、文拉法辛合并消郁汤（研究组B）治疗54例和单纯文拉法辛治疗组45例（对照组）。治疗前及治疗后第1、2、4周末,采用汉密尔顿抑郁量表（HAMD）和治疗中需处理的不良反应症状量表（TESS）进行评定。结果 治疗后第1、2、4周末,3组患者HAMD评分较治疗前降低（P〈0.05）;研究组A和研究组B HAMD评分在治疗后第1、2周末均低于对照组（P〈0.05）;治疗后第4周末,研究组A与研究组B HAMD评分与对照组比较差异无统计学意义（P〉0.05）。3组不良反应发生率比较差异无统计学意义（P〉0.05）。结论 抗抑郁药物合并重复经颅磁刺激或中药消郁汤辅助治疗首发抑郁症比单纯药物治疗早期疗效好,能迅速缓解症状,安全性高。

A control Study about the efficacy of repetitive transcranial magnetic stimulation and Xiaoyu decoction on first-episode depression

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation （rTMS） and Xiaoyu decoction in treatment of the first-episode depression.Methods 139 patients with first-episode depression were randomly divided into study group A （40 cases） treated with Venlafaxine plus rTMS,study group B （54 cases） treated with Venlafaxine plus Xiaoyu decoction and control group （45 cases） treated with Venlafaxine monotherapy for 4 weeks.All patients were assessed with Hamilton Depression Scale （HAMD） and Treatment Emergent Symptom Scale （TESS） to evaluate the efficacy and safety respectively at the baseline and at the end of the 1^st,2^nd and 4^th week of the treatment.Results Compared with the baseline,scores of HAMD in three groups decreased significantly at the end of the 1^st,2^nd and 4^th week （P 〈 0.05）.Scores of HAMD at the end of the 1^st,2^nd week in study group A and study group B were significantly lower than those in control group （P 〈0.05）.However,no significant difference in score of HAMD was found among the three groups at the end of the 4^th week of the treatment （P 〉 0.05）.There was no significant difference in frequency of side effects among the three groups （P 〉 0.05）.Conclusion Antidepressant plus rTMS or Xiaoyu decoction has better efficacy in early stage of treatment than antidepressant monotherapy for first-episode depression.These combination therapies take effect rapidly and has good safety.