经颅直流电刺激联合无抽搐电休克及常规抗抑郁药治疗重度抑郁症的临床疗效分析

doi:10.3969/j.issn.1671-7171.2021.10.019

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摘要【目的】探讨经颅直流电刺激(tDCS)联合无抽搐电休克(MECT)及常规抗抑郁药治疗重度抑郁症(MDD)的临床疗效。【方法】选取2017年3月至2020年10月本院收治的110例MDD患者,根据随机数表法将其分为观察组(n=57)和对照组(n=53)。两组均接受常规抗抑郁药和MECT治疗,观察组在对照组治疗基础上配合经颅直流电刺激治疗。治疗前后分别采用汉密尔顿抑郁量表(HAMD)评估其临床疗效,通过韦氏记忆人工量表、韦氏成人智力量表评估治疗前后两组患者认知功能,比较两组血清脑源性神经营养因子(BDNF)、神经肽(NPY)水平。【结果】治疗后,两组患者HAMD评分显著低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组总有效率为92.98%(53/57),高于对照组的77.36%(41/53),差异有统计学意义(χ²=5.394,P=0.02<0.05)。治疗后,两组患者WMS、WAIS-RC评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组患者血清BDNF水平高于治疗前,血清NPY水平低于治疗前, 且观察组与对照组比较差异均有统计学意义(均P<0.05)。【结论】tDCS联合MECT及常规抗抑郁药治疗MDD的临床疗效较好,可调节患者血清BDNF、NPY水平,有效改善患者认知功能,值得临床借鉴。

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关键词 ：抑郁症, 电刺激疗法/方法, 电惊厥疗法/方法, 抗抑郁药/治疗应用, 治疗结果

Abstract：【Objective】To investigate the clinical efficacy of transcranial direct current stimulation (tDCS) combined with non convulsive electroconvulsive (MECT) and conventional antidepressants in the treatment of severe depression (MDD), and to analyze the effects on the levels of serum brain-derived neurotrophic factor (BDNF) and neuropeptide (NPY). 【Methods】 A total of 110 patients with MDD treated in our hospital from March 2017 to October 2020 was randomly divided into observation group (n=57) and control group (n=53). Both groups were treated with conventional western medicine and MECT. The observation group was treated with transcranial DC stimulation on the basis of the control group. Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy before and after treatment. Wechsler artificial memory scale and Wechsler Adult Intelligence Scale were used to evaluate the cognitive function of the two groups before and after treatment, and the levels of serum brain-derived neurotrophic factor (BDNF) and neuropeptide (NPY) were compared between the two groups. 【Results】 After treatment, the HAMD score of the two groups was significantly lower than that before treatment, and that of the observation group was lower than that of the control group (P<0.05). The total effective rate in the observation group was 92.98% (53/57), which was higher than 77.36% (41/53) in the control group (χ²=5.394, P=0.02 < 0.05). After treatment, the WMS and WAIS-RC scores of the two groups were higher than those before treatment, and the observation group was higher than that of the control group (P<0.05); The level of serum BDNF in the two groups was higher than that before treatment, and the level of serum NPY was lower than that before treatment, and there was significant difference between the observation group and the control group (all P<0.05). 【Conclusion】 tDCS combined with MECT and conventional antidepressants is effective in the treatment of MDD. It can adjust the levels of serum BDNF and NPY and effectively improve the cognitive function of patients, which is worthy of clinical reference.

Key words： Depressive Disorder Electric Stimulation Therapy/MT Electroconvulsive Therapy/MT Antidepressive Agents/TU Treatment Outcome

收稿日期: 2021-03-31

中图分类号:

R749.41

基金资助:佛山市科技创新项目(2020001005608)

引用本文:

李晓玲, 廖海容, 梁嘉权, 俞洋, 谢国军. 经颅直流电刺激联合无抽搐电休克及常规抗抑郁药治疗重度抑郁症的临床疗效分析[J]. 医学临床研究, 2021, 38(10): 1508-1511.
LI Xiao-ling, LIAO Hai-rong, LIANG Jia-quan, et al. Clinical Analysis of Transcranial Direct Current Stimulation Combined with Non Convulsive Electroconvulsive and Conventional Antidepressants in the Treatment of Severe Depression. JOURNAL OF CLINICAL RESEARCH, 2021, 38(10): 1508-1511.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.10.019 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I10/1508

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