艾司西酞普兰联合低频重复经颅磁刺激和心理 干预治疗广泛性焦虑的疗效观察

Efficacy of Escitalopram combined with low frequency repetitive transcranial magnetic stimulation and psychological intervention in the treatment of generalized anxiety

摘要:

目的 探讨艾司西酞普兰联合低频重复经颅磁刺激和心理干预治疗广泛性焦虑的疗效。 方法 选取2018 年4 月—2019 年5 月武警北京市总队医院收治的广泛性焦虑患者88 例，采用随机数字表法 分为观察组和对照组，每组44 例。对照组采用艾司西酞普兰和心理干预治疗，观察组在对照组基础上加低 频重复经颅磁刺激治疗。治疗8 周后，比较两组治疗前后汉密尔顿焦虑量表（HAMA）评分、焦虑自评量表 （SAS）评分的差异，以及治疗第1、3、5 及8 周后副反应量表（TESS）评分变化。结果 观察组治疗后焦虑 状态改善率高于对照组（95.45% VS 79.55%）（P <0.05）。两组治疗前后HAMA、SAS 评分的差值比较，差异 有统计学意义（P <0.05）。观察组与对照组治疗第1、3、5 及8 周TESS 评分比较，采用重复测量设计的方差 分析，①不同时间点的TESS 评分有差别（P <0.05）；②两组TESS 评分有差别（P <0.05），观察组较对照组低； ③两组TESS 评分变化趋势有差别（P <0.05）。结论 艾司西酞普兰联合低频重复经颅磁刺激，配合心理干预 治疗广泛性焦虑效果显著，能有效缓解紧张不安等忧虑情绪，服药后不良状况少，相对安全，进而提高患者的 依从性，具有一定的临床推广价值。

关键词:焦虑;经颅磁刺激;药物疗法;心理疗法;干预性研究

Abstract:

Objective To explore the efficacy of escitalopram combined with low frequency repetitive transcranial magnetic stimulation and psychological intervention in the treatment of generalized anxiety. Methods A total of 88 patients with generalized anxiety admitted to our hospital from April 2018 to May 2019, and randomly divided into the observation group (n = 44) and the control group (n = 44). The control group was treated with escitalopram and psychological intervention. The observation group was treated with low frequency repetitive transcranial magnetic stimulation on the basis of the control group. After 8 weeks, the therapeutic effects of the two groups were compared. The differences of hamilton anxiety scale (HAMA) and selfrating anxiety scale (SAS) scores before and after treatment were observed. The changes of treatment emergent symptom scale (TESS) scores at 1, 3, 5 and 8 weeks after treatment were observed. Results After treatment, the improvement rate of the anxiety state of the observation group was 95.45%, which was higher than that of the control group (79.55%) (P < 0.05). The difference of HAMA score and SAS score before and after treatment was statistically significant between the two groups (P < 0.05). After treatment for 1, 3, 5 and 8 weeks, the TESS scores of the observation group and the control group were compared, and the analysis of variance of repeated measurement design was used. ① The TESS scores of the observation group and the control group were different during different time periods (P < 0.05). ② The TESS scores of the observation group and the control group were different after treatment (P < 0.05), and the TESS scores of the observation group and the control group were lower. ③ The trend of TESS scores between the observation group and the control group was different (P < 0.05). Conclusions Escitalopram combine with low-frequency repetitive transcranial magnetic stimulation and psychological intervention has significant effect on generalized anxiety, which can effectively relieve anxiety such as tension and restlessness. After taking the medicine, there are few adverse conditions, relatively safe, and then improve the compliance of patients, which has a certain clinical promotion value.

Key words:anxiety; transcranial magnetic stimulation; drug therapy; psychotherapy; intervention study