氨磺必利片联合重复经颅磁刺激对老年抑郁症患者的影响

Effects of amisulpride combined with repetitive transcranial magnetic stimulation in elderly patients with depression

摘要:

目的 探讨氨磺必利片联合重复经颅磁刺激对老年抑郁症患者的影响。方法 回顾性分析2021年5月—2025年5月天津市安定医院收治的120例老年抑郁症患者的临床资料，依据不同治疗措施分为对照组、观察组，各60例。对照组予以氨磺必利片治疗，观察组予以氨磺必利片联合重复经颅磁刺激治疗，比较两组抑郁症状［汉密尔顿抑郁量表-17（HAMD-17）］、日常生活能力（Barthel评分）、负性认知偏向［负性认知加工偏向问卷（NCPBQ）］、神经因子水平［血清脑源性神经营养因子（BDNF）、5-羟色胺（5-HT）、多巴胺（DA）］、生活质量［生活质量综合评定问卷（GQOLI-74）］及不良反应。结果 观察组治疗后HAMD-17评分低于对照组，Barthel评分高于对照组，观察组治疗前后HAMD-17评分、Barthel评分的差值均大于对照组（P <0.05）；观察组治疗后NCPBQ各维度评分均低于对照组，观察组治疗前后NCPBQ各维度评分的差值均大于对照组（P <0.05）；观察组治疗后血清BDNF、5-HT、DA水平均高于对照组，观察组治疗前后BDNF、5-HT、DA水平的差值均大于对照组（P <0.05）；观察组治疗后生活质量各维度评分均高于对照组，观察组治疗前后生活质量各维度评分的差值均大于对照组（P <0.05）；观察组不良反应总发生率低于对照组（P <0.05）。结论 氨磺必利片联合重复经颅磁刺激可显著改善老年抑郁患者的抑郁症状、认知功能及生活质量，调节神经递质水平，且安全性良好。

Abstract:

Objective To evaluate the therapeutic efficacy of combining amisulpride with repetitive transcranial magnetic stimulation (rTMS) in the treatment of elderly patients with depression.Methods A retrospective analysis was conducted on 120 elderly patients with depression who were admitted to Anding Hospital from May 2021 to May 2025. The patients were divided into two groups, with 60 cases in each group. Both groups received standard treatment. The control group received amisulpride treatment, while the observation group received amisulpride combined with rTMS. The two groups were compared in terms of depressive symptoms [Hamilton Depression Scale-17 items (HAMD-17) ], activities of daily living [Barthel Index], negative cognitive bias [Negative Cognitive Processing Bias Questionnaire (NCPBQ) ], neurobiological indicators [serum brain-derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), dopamine (DA) ], quality of life [Generic Quality of Life Inventory-74 (GQOLI-74) ], and incidence of adverse reactions.Results After treatment, the observation group showed significantly lower HAMD-17 scores and higher Barthel Index scores compared to the control group. The difference in HAMD-17 scores and Barthel Index scores before and after treatment was greater in the observation group than in the control group (P < 0.05). The observation group also showed significantly lower scores in all dimensions of NCPBQ after treatment, and the difference in NCPBQ scores before and after treatment was greater in the observation group than that of the control group (P < 0.05). Additionally, the observation group had higher levels of BDNF, 5-HT, and DA after treatment, and the difference in these neurobiological markers before and after treatment was greater in the observation group than that in the control group (P < 0.05). The observation group also showed significantly higher GQOLI-74 scores in all dimensions, and the difference in GQOLI-74 scores before and after treatment was greater than that of the control group (P < 0.05). The overall incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05).Conclusion Amisulpride combined with rTMS can significantly improve depressive symptoms, cognitive function, and quality of life in elderly patients with depression, while effectively regulating neurotransmitter levels and demonstrating good safety.