文章摘要
王晓娜 ,王翔 ,苗莉莉 ,顾莹 ,刘敏 ,袁倩.重复经颅磁刺激联合音乐疗法 治疗卒中后抑郁的疗效及机制研究[J].神经损伤功能重建,2021,16(8):459-461
重复经颅磁刺激联合音乐疗法 治疗卒中后抑郁的疗效及机制研究
Effect and Mechanism of Repetitive Transcranial Magnetic Stimulation Combined with MusicTherapy on Post-Stroke Depression
  
DOI:
中文关键词: 卒中后抑郁  重复经颅磁刺激  音乐疗法  康复  联合治疗
英文关键词: post-stroke depression  repetitive transcranial magnetic stimulation  music therapy  rehabilitation  combined therapy
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作者单位
王晓娜1 ,王翔2a ,苗莉莉1 ,顾莹1 ,刘敏1 ,袁倩2b 1. 山东省立第三 医院康复科 2. 山东第一医科 大学附属省立医 院a. 神经内科b. 内分泌科 
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中文摘要:
      目的:探索重复经颅磁刺激(rTMS)联合音乐疗法对卒中后抑郁(PSD)的疗效及其可能机制。方法: PSD患者69例纳入研究,分为对照组(23例)、TMS组(21例)和联合组(25例),分别予以常规康复、常规+ rTMS 康复或常规+rTMS+音乐疗法康复 4 周。于入院后当天及治疗后第 4 周采用汉密尔顿抑郁量表 (HAMD)评估患者抑郁情况,采用改良Barthel指数(mBI)评估患者日常生活能力,测定5-羟色胺(5-HT)水 平。结果:治疗前,3组的HAMD评分、mBI评分和5-HT水平差异无统计学意义(P>0.05)。与治疗前相比, 治疗后第 4 周各组 HAMD 评分均有改善,其中联合组有效率高于其他 2 组(P<0.05);各组的 mBI 评分和 5-HT水平均高于同组治疗前(P<0.05),且联合组高于其他2组(P<0.05)。结论:rTMS联合音乐疗法治疗 PSD可明显降低抑郁量表的评分,提高患者生活质量;其机制可能与5-HT水平升高有关。
英文摘要:
      To observe the effect of repetitive transcranial magnetic stimulation (rTMS) combined with music therapy on post-stroke depression (PSD), and to investigate its possible mechanism. Methods: A total of 69 patients with PSD were divided into the control group (23 cases), TMS group (21 cases), and combined treatment group (25 cases); the groups were treated with conventional therapy, conventional therapy + rTMS, or conventional therapy + rTMS + music therapy, respectively, for 4 weeks. The Hamilton Depression Scale (HAMD) was used to evaluate depression and the modified Barthel index (mBI) to assess activities of daily living in patients at hospital admission and again at 4 weeks after treatment. The serum level of 5-hydroxytryptamine (5-HT) in each group was measured at the same time points. Results: The HAMD score, mBI score, and 5-HT level were not significantly different between the 3 groups before treatment (P>0.05). Compared to before treatment, the HAMD score of each group 4 weeks after treatment showed improvement, and the combined treatment group showed greater effectiveness than the other 2 groups (P<0.05). The mBI score and 5-HT level in each group was higher after treatment compared to the same group before treatment, and the combined group showed a greater increase than those of the other 2 groups (P<0.05). Conclusion: Repetitive TMS combined with music therapy is effective in the treatment of PSD, significantly reducing depression scores and increasing quality of life; the mechanism may be related to the increase in serum 5-HT levels.
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