度洛西汀联合重复经颅磁刺激治疗老年抑郁障碍患者的效果及对脑源性神经营养因子水平的影响

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摘要目的探讨度洛西汀联合重复经颅磁刺激（rTMS）治疗老年抑郁障碍患者的治疗效果以及对血清脑神经营养因子（BDNF）表达水平的影响。方法选取2016年12月至2017年8月在青岛市精神卫生中心住院的60 例老年抑郁症患者，采用随机数字表法分为真刺激组和伪刺激组，每组各30 例。真刺激组采用度洛西汀联合rTMS 治疗，伪刺激组采用度洛西汀联合rTMS 伪刺激治疗。比较并分析两组患者治疗前、治疗8 周末的汉密尔顿抑郁量表（HAMD-17）及可重复神经心理状态测验量表（RBANS）评分；并于入院第2 天和治疗8 周末清晨抽取空腹血标本，检测血清BDNF 水平。结果在治疗8 周末，两组患者的HAMD-17 评分低于治疗前，真刺激组治疗8 周末的HAMD-17 评分低于伪刺激组，差异有统计学意义（P＜0.05）；两组患者治疗8 周末的RBANS 评分均高于治疗前，真刺激组治疗8 周末的RBANS 评分均高于伪刺激组，差异有统计学意义（P＜0.05）。两组患者治疗8 周末血样中的BDNF 水平高于治疗前，真刺激组治疗8 周末的血样中BDNF 水平高于伪刺激组，差异有统计学意义（P＜0.05）。结论度洛西汀联合rTMS 能有效改善老年抑郁障碍患者的抑郁症状及认知功能。

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	高晓
	周田田
	刘珊
	郑占杰

关键词 ：度洛西汀, 重复经颅磁刺激, 抑郁症, 脑神经营养因子, 认知功能

Abstract：Objective To investigate the therapeutic effect of Duloxetine combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of elderly patients with depressive disorder and its influence on the expression of serum brain neurotrophic factor (BDNF). Methods A total of 60 elderly depressive patients in Qingdao Mental Health Center were selected from December 2016 to August 2017. All patients were divided into the true stimulation group and the pseudo stimulation group according to random number table methods, 30 cases in each group. Patients in the true stimulation group were treated with Duloxetine and combined with rTMS, while patients in the pseudo stimulation group were treated with Duloxetine and combined with rTMS pseudo stimulation. The 17-item Hamilton depression rating scale (HAMD-17) and the repeatable battery for the assessment of neuropsychological status (RBANS) were compared and analyzed before treatment and 8 weeks after treatment. Fasting blood samples were taken on the second day of admission and the morning of the 8th weekend of treatment to detect the level of serum BDNF. Results At the end of 8 weeks of treatment, the HAMD-17 scores of the two groups were lower than those before treatment, and the HAMD-17 score of the true stimulation group was lower than that of the pseudo stimulation group at the end of 8 weeks of treatment, the differences were statistically significant (P＜0.05). The RBANS scores of the two groups at the end of 8 weeks of treatment were higher than those before treatment, and the RBANS scores of the real stimulation group at the end of 8 weeks of treatment were higher than those of the pseudo stimulation group, the differences were statistically significant (P＜0.05). The levels of BDNF in blood samples of the two groups at the end of 8 weeks of treatment were higher than those before treatment, and the level of BDNF in blood samples of the real stimulation group at the end of 8 weeks of treatment was higher than that of the pseudo stimulation group, the differences were statistically significant (P＜0.05). Conclusion Duloxetine combined with low rTMS can effectively improve cognitive function and the symptoms of depression in the treatment of depression in older patients.

Key words： Duloxetine Repetitive transcranial magnetic stimulation Depression Brain derived neurotrophic factor;Cognitive function

基金资助:山东省青岛市医药科研指导计划项目（2014-WJZD153）

通讯作者: 郑占杰（1969-），男，主任医师，研究方向：老年精神病学

作者简介: 高晓（1991-），男，硕士，研究方向：老年精神病学

引用本文:

高晓；周田田；刘珊；郑占杰. 度洛西汀联合重复经颅磁刺激治疗老年抑郁障碍患者的效果及对脑源性神经营养因子水平的影响[J]. 中国当代医药, 2021, 28(28): 96-99.
GAO Xiao；ZHOU Tian-tian；LIU Shan；ZHENG Zhan-jie. Effect of Duloxetine combined with repetitive transcranial magnetic stimulation in the treatment of elderly patients with depressive disorder and its influence on the level of brain-derived neurotrophic factor. 中国当代医药, 2021, 28(28): 96-99.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I28/96

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