重复经颅磁刺激治疗冠心病合并脑梗死迟发性癫痫患者焦虑抑郁共病

摘要

Objective To investigate the clinical efficacy and safety of repeated transcranial magnetic stimulation in the treatment of post-stroke delayed-onset epilepsy with anxiety and depression.Methods Eighty patients with post-stroke delayed epilepsy and anxiety and depression admitted to our hospital from May 2015 to May 2017 were randomly divided into control group (n = 40) and observation group (n = 40).Patients in the control group were treated with routine clinical treatment.The observation group was treated with repeated transcranial magnetic stimulation on the basis of routine treatment, and the clinical efficacy and safety of the two groups were compared.Results Before treatment, there was no significant difference between HAMD score, HAMA score and NIHSS score in both groups (P＞0. 05).After treatment, the two groups of patients The score of each scale was significantly improved, and the improvement effect of the observation group was better than that of the control group (P＜0. 05).After the treatment, the levels of norepinephrine and serotonin in the observation group were (0. 46±0. 08) μmol/L, (36. 82±10. 86) ng/mL and the control group were (0. 31±0. 09) μmol/L and (47. 69±11. 64) ng/mL, respectively, the differences between the two groups were statistically significant (P＜0. 05).The incidence of adverse reactions was significantly lower in the observation group than in the control group (P＜0. 05).Conclusion Post-stroke delayed epilepsy patients with anxiety and depression in patients with common clinical treatment based on repeated transcranial magnetic stimulation therapy can effectively improve the patient's clinical symptoms and improve neurological function, the effect is significant, and higher safety, with more High clinical promotion value.%目的 探讨重复经颅磁刺激治疗冠心病合并脑梗死后迟发性癫痫患者焦虑抑郁共病的临床疗效及安全性.方法选取80例冠心病合并脑梗死后迟发性癫痫合并焦虑抑郁患者,采用随机双盲法随机均分为对照组(n=40)和观察组(n=40).对照组采用临床常规治疗,观察组在常规治疗的基础上采用重复经颅磁刺激治疗,对比2组临床疗效及安全性.结果 治疗前2组汉密尔顿抑郁量表(HAMD)评分、焦虑量表(HAMA)评分和神经功能缺损程度(NIHSS)评分相比均无显著性差异(P＞0.05);治疗后2组各量表评分均显著改善,且观察组改善效果优于对照组(P＜0.05);治疗后观察组去甲肾上腺素水平和5-羟色胺水平分别为(0.46±0.08)μmol/L、(36.82±10.86)ng/mL,对照组分别为(0.31±0.09)μmol/L、(47.69±11.64)ng/mL,2组相比差异有统计学意义(P＜0.05);观察组不良反应发生率显著低于对照组(P＜0.05).结论 冠心病合并脑梗死后迟发性癫痫患者焦虑抑郁共病在临床常规治疗的基础上给予重复经颅磁刺激治疗可有效改善患者的临床症状,提高神经功能,效果显著,安全性较高.