经颅直流电刺激对抑郁症患者疗效及认知功能的影响

曹江; 张岩; 袁娜华; 朱桂东

doi:10.16766/j.cnki.issn.1674-4152.003457

经颅直流电刺激对抑郁症患者疗效及认知功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.003457

丽水市第二人民医院六病区，浙江丽水 323000

基金项目:

浙江省基础公益研究计划项目 LGF22H090055

详细信息

通讯作者:
朱桂东，E-mail: chgzhcj518888@163.com

中图分类号: R749.4 R454.1
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- 文章访问数: 278
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-27
- 网络出版日期: 2024-05-29

Effects of transcranial direct current stimulation on therapeutic effect and cognitive function in patients with depression

The Sixth Ward of the Second People's Hospital of Lishui, Lishui, Zhejiang 323000, China

摘要

摘要: 目的探究经颅直流电刺激(tDCS)对抑郁症患者的治疗效果，并观察其对患者认知功能的影响，以期为临床应用tDCS治疗抑郁症提供参考依据。方法选取丽水市第二人民医院2023年3—12月收治的抑郁症患者112例为研究对象，依据是否进行tDCS治疗，将患者分为对照组(55例)和tDCS组(57例)。比较2组患者17项汉密顿抑郁量表(HAMD-17)评分、威斯康星卡片分类测验(WCST)评分及不良反应发生情况。结果治疗后，tDCS组患者总有效率高于对照组[89.47%(51/57) vs. 69.09%(38/55)，P＜0.01]。治疗前, 2组患者HAMD-17评分、WCST评分比较差异均无统计学意义(P＞0.05)。治疗后，2组患者HAMD-17评分明显降低(P＜0.05)，治疗4周后，tDCS组患者HAMD-17评分低于对照组[(10.64±2.57)分vs. (15.82±2.96)分]。治疗4周后，tDCS组患者WCST中5项评分均优于对照组(P＜0.001)，患者认知功能改善显著。治疗过程中2组均出现不良反应，对照组恶心1例，tDCS组皮肤刺痛1例，恶心1例，2组患者不良反应发生情况比较差异无统计学意义(P＞0.05)。结论 tDCS能有效缓解抑郁症患者临床症状，效果明显，并能改善抑郁症患者的认知功能。
- 经颅直流电刺激 /
- 抑郁症 /
- 认知功能 /
- 治疗效果
Abstract: Objective To investigate the therapeutic effect of transcranial direct current stimulation (tDCS) on patients with depression, and to observe its influence on the patients' cognitive function in order to provide a reference for the clinical application of tDCS in the treatment of depression. Methods A total of 112 patients with depression admitted to the Second People's Hospital of Lishui from March to December 2023 were selected as observation objects, and divided into control group (n=55) and tDCS group (n=57) according to whether they were treated with tDCS or not. The 17-item Hamilton depression scale (HAMD-17) score, Wisconsin card sorting test (WCST) score, and adverse reactions were compared between the two groups. Results After treatment, the overall efficacy rate of the tDCS group was higher than that of the control group [89.47% (51/57) vs. 69.09% (38/55), P < 0.01]. Before treatment, there was no significant difference in HAMD-17 score and WCST score between the two groups (P>0.05). After treatment, the HAMD-17 scores of both groups were significantly decreased (P < 0.05). After 4 weeks of treatment, the HAMD-17 score of the tDCS group was lower than that of the control group [(10.64±2.57) points vs. (15.82±2.96) points]. After 4 weeks of treatment, the 5-item WCST scores of the tDCS group were better than those of the control group (P < 0.001), and the patients' cognitive function was significantly improved. During treatment, adverse events occurred in both groups, including 1 case of nausea in the control group, 1 case of skin tingling, and 1 case of nausea in the tDCS group. There was no statistically significant difference in side effects between the two groups (P>0.05). Conclusion tDCS can effectively relieve the clinical symptoms of depression patients, the effect is obvious, and can improve the cognitive function of depression patients.
- Transcranial direct current stimulation /
- Depression /
- Cognitive function /
- Therapeutic effect

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表 1 2组抑郁症患者治疗总有效率比较[例(%)]

Table 1. Comparison of the overall effective rate of treatment for patients with depression betwwen the two groups[cases(%)]

组别	例数	痊愈	显效	有效	无效	总有效
对照组	55	12(21.82)	13(23.64)	13(23.64)	17(30.91)	38(69.09)
tDCS组	57	22(38.60)	19(33.33)	10(17.54)	6(10.53)	51(89.47)
注：2组总有效率比较，χ²=7.126，P=0.007。

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表 2 2组抑郁症患者治疗前后HAMD-17评分比较(x ± s，分)

Table 2. Comparison of HAMD-17 scores before and after treatment between the two groups of depressed patients(x ± s, points)

组别	例数	治疗前	治疗2周后	治疗4周后
对照组	55	30.24±4.72	23.76±3.79^a	15.82±2.96^ab
tDCS组	57	30.83±4.57	16.24±3.03^a	10.64±2.57^ab
F值		0.627	2 031.267	5 031.202
P值		0.503	< 0.001	< 0.001
注：与同组治疗前比较，^aP＜0.05；与同组治疗2周后比较，^bP＜0.05。

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表 3 2组抑郁症患者治疗前后WCST得分比较(x ± s，分)

Table 3. Comparison of WCST scores before and after treatment between the two groups of depressed patients(x ± s, points)

组别	例数	总反应数		正确反应数		错误应答数		持续错误数		完成分类数
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	55	98.21±8.32	109.27±11.84^b	65.87±5.72	75.31±6.04^b	47.33±4.17	31.34±3.91^b	37.12±3.22	25.74±2.29^b	2.54±0.64	3.41±0.98^b
tDCS组	57	97.84±8.56	118.15±12.27^b	66.12±5.57	87.36±6.87^b	47.05±4.25	25.83±3.22^b	36.93±3.16	20.88±1.84^b	2.59±0.62	4.13±1.07^b
统计量		0.232^a	236.345^c	0.234^a	182.265^c	0.352^a	726.284^c	0.315^a	201.639^c	0.420^a	637.109^c
P值		0.817	＜0.001	0.815	< 0.001	0.726	< 0.001	0.753	< 0.001	0.675	＜0.001
注：^a为t值，^c为F值; 与同组治疗前比较，^bP < 0.05。

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