| 朱宁,赵伟丽,朱洪山,等.重复经颅磁刺激联合盐酸帕罗西汀对卒中后抑郁症患者治疗效果观察[J].安徽医药,2018,22(12):2431-2434. |
| 重复经颅磁刺激联合盐酸帕罗西汀对卒中后抑郁症患者治疗效果观察 |
| Effects of rTMS combined with paroxetine hydrochloride on HAMD score and serum NPY,BDNF and CRF levels in patients with post-stroke depression |
| 投稿时间：2017-09-22 |
| DOI： |
| 中文关键词: 重复经颅磁刺激 盐酸帕罗西汀 卒中后抑郁症 HAMD评分 神经肽Y 脑源性神经营养因子 促肾上腺皮质激素释放因子 |
| 英文关键词: rTMS Paroxetine hydrochloride Post-stroke depression HAMD score NPY BDNF CRF |
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| 中文摘要: |
| 目的 探讨重复经颅磁刺激(rTMS)联合盐酸帕罗西汀对卒中后抑郁症(PSD)患者HAMD评分及血清神经肽Y(NPY)、促肾上腺皮质激素释放因子(CRF)、脑源性神经营养因子(BDNF)水平变化的影响。 方法 选取郑州大学第二附属医院2014年11月至2017年2月PSD患者68例,随机数字表法分组,各34例。对照组采用盐酸帕罗西汀,观察组采用盐酸帕罗西汀+rTMS,两组均持续治疗2个月。入院时及治疗结束后统计对比两组抑郁评分(HAMD、MARDS、SDS)、血清NPY、BDNF、CRF水平、临床疗效及不良反应发生率。 结果 ①两组治疗后MARDS、HAMD及SDS分值低于治疗前,且观察组较对照组低(P＜0.05)；②两组治疗有效率比较,观察组94.12%(32/34)较对照组64.71%(22/34)高(P＜0.05)；③两组治疗后血清CRF水平低于治疗前,BDNF及NPY水平高于治疗前,且观察组各指标优于对照组(P＜0.05)；④两组不良反应发生率比较,观察组14.71%(5/34)与对照组8.82%(3/34)间差异无统计学意义(P＞0.05)。 结论 联合采用盐酸帕罗西汀及rTMS治疗卒中后抑郁症效果显著,可有效改善血清NPY、BDNF、CRF水平,降低HAMD评分,减轻患者抑郁程度,提高治疗效果,且不会增加不良反应发生风险,具有安全性。 |
| 英文摘要: |
| Objective To evaluate the HAMD score of repeated transcranial magnetic stimulation (rTMS) combined with paroxetine hydrochloride in patients with post-stroke depression (PSD) and the change of serum neuropeptide Y (NPY),corticotropin releasing factor (CRF) and brain-derived neurotrophic factor (BDNF) levels. Methods 68 patients with PSD in the second affiliated hospital of Zhengzhou university from November 2014 to February 2017 were randomly divided into 2 groups.The control group was treated with paroxetine hydrochloride and the study group was treated with paroxetine hydrochloride + rTMS.The two groups were treated for 2 months.The depression score (HAMD,MARDS,SDS),serum NPY,BDNF,CRF levels,clinical efficacy and adverse reactions were statistically compared between the two groups at admission and at the end of treatment. Results ①After treatment,the scores of MARDS,HAMD and SDS in the two groups were lower than those before treatment,and the study group was lower than that in the control group (P<0.05).② The effective rate of the two groups was 94.12% (32/34) higher than that of the control group 64.71% (22/34) (P<0.05).③ After treatment,the serum CRF level of the two groups was lower than that before treatment.The levels of BDNF and NPY were higher than those before treatment,and the indexes in the study group were better than those in the control group (P<0.05).④ The incidence of adverse reactions was not statistically significant between the study group 14.71% (5/34) and the control group 8.82% (3/34)(P＞0.05). Conclusion Paroxetine hydrochloride combined with rTMS is effective in the treatment of post-stroke depression,which can effectively improve the serum levels of NPY,BDNF,CRF and reduce the HAMD score.It reduces the degree of depression,improve the treatment effect and does not increase the risk of adverse reactions and is safe. |
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