| 徐彩霞,汤超华,俞洋,黎润仪,邓丹文,谢国军.高频rTMS联合度洛西汀对青年首发广泛性焦虑障碍的疗效及认知功能的影响[J].四川精神卫生杂志,2020,33(4):326-329.Xu Caixia,Tang Chaohua,Yu Yang,Li Runyi,Deng Danwen,Xie Guojun,Clinical efficacy of high-frequency rTMS combined with duloxetine for adolescents with first-episode generalized anxiety disorder and its effect on cognitive function[J].SICHUAN MENTAL HEALTH,2020,33(4):326-329 |
| 高频rTMS联合度洛西汀对青年首发广泛性焦虑障碍的疗效及认知功能的影响 |
| Clinical efficacy of high-frequency rTMS combined with duloxetine for adolescents with first-episode generalized anxiety disorder and its effect on cognitive function |
| 投稿时间：2020-02-25 |
| DOI：10.11886/scjsws20200225006 |
| 中文关键词: 高频重复经颅磁刺激 广泛性焦虑障碍 认知功能 |
| 英文关键词:High-frequency rTMS Generalized anxiety disorder Cognitive function |
| 基金项目:佛山市医学类科技攻关项目（项目名称：青年期广泛性焦虑障碍的认知缺陷、内分泌变化的关联影响及干预研究，项目编号：2018AB002871）；佛山市十三五医学重点专科和特色专科建设（项目编号：FSTSZK002） |
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| 中文摘要: |
| 目的 探讨高频重复经颅磁刺激（rTMS）联合度洛西汀对青年首发广泛性焦虑障碍（GAD）的临床疗效、安全性及对认知功能的影响。方法 将符合《国际疾病分类 (第10版）》（ICD-10）广泛性焦虑障碍诊断标准的90例首发青年患者分为研究组和对照组，研究组接受高频rTMS（10 Hz）联合度洛西汀治疗，对照组接受伪经颅磁刺激联合度洛西汀治疗，观察期4周。于治疗前采用汉密尔顿抑郁量表17项版（HAMD-17）评定抑郁状况，治疗前和治疗第1、2、4周末采用汉密尔顿焦虑量表（HAMA）评定疗效，治疗前和治疗第4周末使用MATRICS共识认知成套测验（MCCB）评定认知功能，治疗第4周末采用副反应量表（TESS）评定不良反应。结果 治疗后各时点，两组HAMA评分均较同组治疗前低（P均<0.01）。治疗4周末，研究组治疗总有效率高于对照组（88.89% vs.73.81%，χ2=2.100，P=0.040），研究组推理及问题解决、社会认知领域评分均高于对照组（P均<0.05）。治疗后，两组TESS评分比较差异无统计学意义[（2.48±0.86）分vs.（2.14±0.78）分，χ2=0.640，P=0.420]。结论 高频rTMS联合度洛西汀对GAD的疗效更好，且有助于改善推理及问题解决、社会认知等认知功能。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with duloxetine for adolescents with first-episode generalized anxiety disorder(GAD), and to analyze its effect on cognitive function.Methods A total of 90 adolescents who met the diagnostic criteria of the International Classification of Diseases, tenth edition (ICD-10) for first-episode GAD were included, and divided into two groups. Study group received high-frequency rTMS (10 Hz) combined with duloxetine, whereas control group received pseudo rTMS combined with duloxetine for 4 weeks. Hamilton Depression Scale - 17 item (HAMD-17) was used to assess the depressive symptoms before the treatment. Hamilton Anxiety Scale (HAMA) was used to evaluate efficacy at the baseline and the 1st, 2nd and 4th weekend of the treatment. MATRICS Consensus Cognitive Battery (MCCB) was used to evaluate cognitive function at the baseline and the 4th weekend of treatment, and TESS was used to evaluate adverse reactions at the 4th weekend of treatment.Results Compared with baseline data, HAMA scores were decreased in both groups after treatment (P<0.01). At the 4th weekend of treatment, the total response rate of study group was higher than that of control group (88.89% vs. 73.81%, χ2=2.100, P=0.040), and the scores of reasoning, problem solving and social cognition of study group were higher than those of control group (P<0.05). After treatment, TESS score showed no significant difference between groups [(2.48±0.86) vs. (2.14±0.78), χ2=0.640, P=0.420].Conclusion High-frequency rTMS combined with duloxetine has a better efficacy on GAD, and it can effectively improve cognitive functions such as reasoning, problem solving and social cognition. |
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