目的 观察经颅直流电刺激(tDCS)对卒中后抑郁(PSD)患者情绪及认知功能的影响。方法 2017年2月至8月,PSD患者26例随机分为对照组和实验组各13例。在舍曲林治疗基础上,实验组采用tDCS治疗,对照组采用假刺激治疗,共4周。治疗前后采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和简易精神状态检查(MMSE)进行评估。结果 实验组12例、对照组10例完成研究。治疗后,两组HAMD、HAMA和MMSE评分均较治疗前改善(t>2.331, P<0.05),治疗前后差值两组间均无显著性差异(t<1.642, P>0.05)。治疗后,实验组HAMD焦虑/躯体化因子、认知障碍因子、迟缓因子与绝望感因子分降低(t>2.493, P<0.05),对照组绝望感因子分降低(t=2.862, P<0.05);各因子分差值组间比较,迟缓因子分有显著性差异(t=2.354, P<0.05)。结论 tDCS对PSD患者的抑郁情绪有一定效果。
Objective To observe the effects of transcranial direct current stimulation (tDCS) on depression, anxiety and cognitive function in patients with post-stroke depression (PSD). Methods From February to August, 2017, 26 patients with PSD were randomly divided into control group (n=13) and treatment group (n=13). All the patients accepted sertraline, while the treatment group accepted tDCS, and the control group accepted sham stimulation. They were evaluated with Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Mini-Mental State Examination (MMSE) before and after treatment. Results Twelve patients in the treatment group and ten patients in the control group completed the trial. The scores of HAMD, HAMA and MMSE improved in both groups (t>2.331, P<0.05), and there was no significant difference between two groups (t<1.642, P>0.05). The scores of anxiety/somatization factor, cognitive impairment factor, retardation factor and despair factor of HAMD improved in the treatment group after treatment (t>2.493, P<0.05), while only despair factor improved in the control group (t=2.862, P<0.05). The score of retardation factor was significantly different between two groups (t=2.354, P<0.05).Conclusion tDCS may work for the depression in PSD patients.
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