帕罗西汀联合重复经颅磁刺激治疗女性更年期抑郁症的对照研究

摘要

Objective To investigate the clinical efficacy of paroxetine combined repetitive transcranial magnetic stimulation (rTMS)on patients with female climacteric depression. Methods A total of 72 patients of female climacteric depression were randomly divided into study group(36 cases)and control group(36 cases),the study group was treated with paroxetine combined rTMS, and the control group was treated with paroxetine. The efficacy was assessed with Hamilton Depression Scale - 17 item(HAMD - 17), Hamilton Anxiety Scale(HAMA)and Center for Epidemiological Survey,Depression Sale(CES - D)before treatment and after treat-ment for 1,2,4,6 weeks,adverse effect was evaluated with Treatment Emergent Symptom Scale(TESS). Results The effective rate were 94. 4% and 75. 0% in study group and control group,respectively,the difference was statistically significant( P < 0. 01). Starting from the 1st weekend of treatment,the HAMD - 17,HAMA and CES - D scores of study group decreased significantly com-pared with the baseline(P < 0. 01). Starting from the 2nd weekend of treatment,the HAMD - 17,HAMA and CES - D scores of con-trol group decreased significantly compared with the baseline(P < 0. 01). There were significant differences in those scores between the two groups at the same time after treatment(P < 0. 01). By the end of the treatment,there was no significant difference in TESS score between the two groups(P > 0. 05). Conclusion Paroxetine combined with rTMS is as effective as paroxetine for the treatment of female climacteric depression patients,and takes effect earlier.%目的：探讨帕罗西汀联合重复经颅磁刺激（rTMS）对女性更年期抑郁症的疗效。方法采用随机数字表法将符合《国际疾病分类（第10版）》（ICD -10）抑郁症诊断标准的72例更年期女性患者分为研究组和对照组各36例，研究组采用帕罗西汀联合 rTMS 治疗，对照组单用帕罗西汀治疗，采用汉密尔顿抑郁量表17项版（HAMD -17）、汉密尔顿焦虑量表（HAMA）、流调用抑郁自评量表（CES - D）于治疗前及治疗后第2、4、6、8周评定疗效，采用副反应量表（TESS）评定不良反应。结果研究组与对照组有效率分别为94.4%和75.0%，差异有统计学意义（P ＜0.01）。从治疗第1周末开始，研究组 HAMD -17、HAMA 及 CES - D 评分与治疗前比较，差异均有统计学意义（P 均＜0.01），从治疗第2周末开始，对照组 HAMD -17、HAMA 及 CES - D 评分与治疗前比较，差异均有统计学意义（P 均＜0.01）。治疗后两组同期比较差异有统计学意义（P ＜0.01）。治疗结束时两组 TESS 评分差异无统计学意义（P ＞0.05）。结论帕罗西汀联合 rTMS 对女性更年期抑郁症疗效优于单用帕罗西汀，起效较快。