摘要

【摘要】
目的 探讨高频重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）联合选择性5-羟色胺再摄取抑制剂（selective serotonin reuptake inhibitors，SSRIs）治疗青少年非自杀性自伤（non-suicidal self-injury，NSSI）的效果。

方法 选择青少年抑郁症患者226例，随机分为对照组（n=113，予以SSRIs治疗）和观察组（n=113，予以SSRIs+高频rTMS治疗）。比较两组治疗效果、汉密尔顿抑郁量表（Hamilton Depression Rating Scale，HAMD）、渥太华自伤量表（Ottawa Self-Injury Inventory，OSI）、Barratt冲动量表（Barratt Impulsiveness Scale-11，BIS-11）评分及脑源性神经营养因子（Brain-Derived Neurotrophic Factor，BDNF）、5-羟色胺（5-Hydroxytryptamine，5-HT）、神经肽Y（Neuropeptide Y，NPY）水平和不良反应。

结果 与对照组比较，观察组总有效率更高，且在治疗后HAMD、OSI、BIS-11评分均更低（P＜0.05）。两组在治疗后BDNF、5-HT、NPY水平均增高（P＜0.05），但组间比较无差异（P＞0.05）。两组不良反应比较相当（P＞0.05）。

结论 高频rTMS联合SSRIs治疗青少年NSSI可快速缓解患者抑郁症状，减少其自伤行为，疗效显著且安全。

关键词：【关键词】 重复经颅磁刺激；选择性5-羟色胺再摄取抑制剂；青少年；非自杀性自伤

ABSTRACT

【Abstract】
Objective To exploring the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with selective serotonin reuptake inhibitors (SSRIs) in the treatment of non suicidal self injury (NSSI) in adolescents.

Methods 226 adolescent patients with depression were randomly divided into a control group (n=113, treated with SSRIs) and an observation group (n=113, treated with SSRIs+high-frequency rTMS).. Compare the therapeutic effects, Hamilton Depression Rating Scale (HAMD), Ottawa Self Injury Inventory (OSI), Barratt Impulsiveness Scale-11 (BIS-11) scores, and levels and adverse reactions of Brain Driven Neurotrophic Factor (BDNF), 5-hydroxytryptamine (5-HT), neuropeptide Y (NPY) between two groups.

Results Compared with the control group, the observation group had a higher overall effective rate and lower HAMD, OSI, and BIS-11 scores after treatment (P<0.05). After treatment, the levels of BDNF, 5-HT, and NPY increased in both groups (P<0.05), but there was no significant difference between the groups (P>0.05). The adverse reactions of the two groups were comparable (P>0.05).

Conclusion   The combination of high-frequency rTMS and SSRIs in the treatment of adolescent NSSI can quickly alleviate depressive symptoms and reduce self harm behavior, with significant and safe therapeutic effects.

Key words: 【Key words】 Repetitive transcranial magnetic stimulation; Selective serotonin reuptake inhibitors; Teenagers; Non-Suicidal Self-Injury