【摘要】目的 比较重复经颅磁刺激(rTMS)与度洛西汀对广泛性焦虑障碍的疗效以及认知功能的影响。方法 选择性别、年龄、文化程度相匹配的两组各30例广泛性焦虑障碍患者为研究对象，两组分别接受rTMS治疗和度洛西汀治疗。分别于治疗前和治疗第1周末、第2周末、第4周末采用汉密顿焦虑量表(HAMA)评定疾病严重程度并作为疗效指标。治疗前和治疗后第4周末各采用事件相关电位P300、威斯康星卡片分类测验(WCST)评定患者认知功能。结果 1.治疗前，两组患者HAMA评分比较差异无统计学意义(P＞0.05)；治疗后，两组患者组内比较示HAMA评分逐渐降低，差异具有统计学意义(P<0.001)，但各时点两组患者HAMA评分比较，差异均无统计学意义(P＞0.05)。2.治疗后两组P300潜伏期与治疗前比差异无统计学意义(P＞0.05)，治疗后与治疗前比两组P300波幅延长，差异有统计学意义(P<0.05).3.rTMS组治疗后WCST操作的正确应答数和完成分类数均高于治疗前，差异有统计学意义(p<0.05)；度洛西汀组治疗后WCST操作的持续错误数和随机错误数均较前治疗前减少，差异有统计学意义(p<0.05)。结论 重复经颅磁刺激(rTMS)与度洛西汀治疗广泛性焦虑障碍疗效相当，而且两者均能不同程度改善广泛性焦虑障碍患者的认知功能。
关键词：【关键词】 广泛性焦虑障碍 认知功能 P300 WCST
【Abstract】Object To compare the effect and cognitive function of generalized anxiety disorder patients after rTMS and Duloxetine treatment. Methods 60 patients are parallel assigned two groups receiving rTMS（n=30）and Duloxetine（n=30）treatment.Using Hamilton Anxiety scale (HAMA) to evaluate severity of disease and as a therapeutic index.and using WSCT neuropsychological tests and performing P300 test twice before and after treatment to evaluate the cognition function of the two groups patients. Result 1.Before treatment,HAMA score between the two groups had no significant difference(P＞0.05); Within group comparisons, HAMA score of the two groups had decreased, the difference had statistically significant (P<0.001),but 2,4,6 weeks after treatment ,HAMA Score between the two groups had no significant differences. 2.The difference of P300 latency in the two groups after treatment and before treatment had no statistically significant(P＞0.05);Compared with before treatment,two groups patients after treatment had longer p300 amplitude(P<0.05);3.After treatment, The patients with rTMS treatment had improvement in WSCT correct numbers and sorting numbers(P<0.05);With Duloxetine treatment had decrease in WCST Perseverative Errors and not Perseverative Errors(P<0.05). Conclusion The efficacy of repetitive transcranial magnetic stimulation (rTMS) and Duloxetine in treatment of GAD is fairly,and rTMS and Duloxetine can improve the cognitive function of generalized anxiety disorder patient.
Key words: 【Key words】Generalized Anxiety Disorder; cognitive function; p300;WCST.
引用本文 / How to Cite This Article
孙太鹏,黄成兵,王秀珍,杨海英,陈刚,郑直.rTMS与度洛西汀治疗广泛性焦虑的疗效以及认知改善的对照研究[J]. 国际精神病学杂志, , (): -