Rs-fMRI技术下电针结合抗抑郁类药物治疗原发性抑郁症的疗效研究

摘要

Objective:To evaluate the efficacy of electro-acupuncture combined with antidepressant medicine in the treatment of primary depression with Rs-fMRI technique.Methods:198 patients with depression were randomly divided into two groups,the medication group(n =99) and the combination group (n =99).Patients in the medication group was treated with antidepressant medicine;on which basis,the combination group was also treated with electro-acupuncture.The Hamilton Depression Scale (HAMD) was used to determine the depression condition.The deduction of HAMD score was used as the evaluation index of clinical efficacy,and the side effects scale (SERS) was used as the evaluation index of side effects.Results:The results showed that the efficacy of the combination group was significantly higher than that of the medication group on week 2 (P ＜ 0.05).The scores of SERS was obviously lower on week 2 after the treatment than that before the treatment,however this change happened on week 1 in the combination group;of which,it was significantly lower in the combination group than that in the medication group (P ＜ 0.05).HAMD score started to decrease on week 4 in the medication group;however,it decreased on week 1 in the combination group;HAMD score was greatly lower in the combination group than that in the medication group (P ＜ 0.05).The Rs-fMRI images showed that the combination group could cause more signal changes of ALFF in brain.Conclusion:The therapy of electro-acupuncture combined with Paroxetine is effective in the treatment of primary depression,with its fast action.%目的:评价静息态功能磁共振成像(Rs-fMRI)技术下电针结合抗抑郁类药物治疗原发性抑郁症的疗效.方法:选择2013年1月至2016年12月来我科室就诊的抑郁症患者198例,根据随机数字表法随机分为两组,药物组99例患者采用抗抑郁症药物治疗,联合组99例患者在药物治疗的基础上,结合电针疗法治疗.采用汉密尔顿抑郁量表(HAMD)进行抑郁情况判定,以HAMD总分的减分率作为临床疗效的评价指标,抗抑郁药副反应量表(SERS)做为副作用评价指标.结果:研究结果显示,第2周联合组的有效率显著高于药物组(P＜0.05);药物组治疗后第2周SERS总分显著低于治疗前,而联合组在治疗后第1周SERS总分就显著低于治疗前,两组比较联合组均显著低于药物组(P＜0.05);药物组从治疗后第4周HAMD总分才显著降低,而联合组在治疗后第1周HAMD总分就显著低于治疗前,组间比较联合组治疗后HAMD总分均显著低于药物组(P＜0.05).Rs-fMRI影像结果显示,联合组可以使更多的脑区ALFF信号发生改变.结论:电针联合帕罗西汀治疗原发性抑郁症起效快,效果显著.