| 摘要 |
探讨间歇性θ脉冲刺激（Intermittent Theta Burst Stimulation, iTBS）模式重复经颅磁刺激（Repetitive Transcranial Magnetic Stimulation, rTMS）治疗首发青少年抑郁症中非自杀性自伤（Non-Suicidal Self-Injury, NSSI）行为的疗效。方法 选择在宜昌市优抚医院门诊及住院的首发伴NSSI行为的青少年抑郁症患者80例，随机分为研究组和对照组。对照组给予单一药物治疗（n=36），研究组在对照组的基础上联合iTBS模式rTMS治疗（n=38），于治疗前、第2周、第4周采用汉密尔顿抑郁量表（Hamilton depression scale, HAMD）评定其病情，TESS量表（Treatment Emergent Symptom Scale， TESS）记录其不良反应，于治疗前和第4周四采用Barratt冲动量表（Barratt Impulsiveness Scale，BIS-II）中文修订版评定其冲动行为，用青少年非自杀性自伤行为功能评估量表评定其自伤水平。结果 治疗2周后，研究组较治疗前已有显著差异（t=2.08，P=0.04），第四周时两组患者HAMD评分均较治疗前显著减少（t=7.03，4.93，P均<0.01），且组间存在显著差异（t=3.10，P<0.01）。治疗4周后两组患者BIS-II中文修订版评分和青少年非自杀性自伤行为功能评估量表评分较治疗前均显著减少（t=15.19，12.83，8.66，15.76，P均<0.01），且研究组该项评分显著低于对照组（t=2.29，2.50，P=0.03，0.02）。结论 iTBS模式rTMS能显著降低伴有非自杀性自伤行为青少年抑郁症患者的抑郁情绪及自伤水平，安全有效。
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| Abstract |
Objective To investigate the efficacy of repetitive transcranial magnetic stimulation （rTMS） in intermittent theta burst stimulation （iTBS） mode in the treatment of non-suicidal self-injury （NSSI） behaviors in first-episode adolescents with depression. Methods A total of 80 adolescent depression patients with NSSI behavior who were outpatient and inpatient in our hospital were selected and randomly divided into a study group and a control group. The control group was given single drug treatment (n=36), and the study group was given iTBS mode rTMS treatment on the basis of the control group (n=38). Before treatment, in the 2nd week and the 4th week, their condition was assessed by HAMD, and their adverse reactions were recorded by TESS scale. Before treatment and on the 4th Thursday, their impulsive behavior was assessed by the Chinese revised version of the BIS-II Scale, and their self-injury level was assessed by the Adolescent Non-Suicidal Self-Injury Behavior Functional Assessment Scale. Results After 2 weeks of treatment, there was a significant difference in the study group compared with before treatment (t=2.08, P=0.04). At the fourth week, the HAMD scores of the two groups of patients were significantly lower than those before treatment (t=7.03, 4.93, all P<0.01), and there was a significant difference between the groups (t=3.10, P<0.01). After 4 weeks of treatment, the BIS-II Chinese revised version score and the Adolescent Non-Suicidal Self-Injury Behavior Functional Assessment Scale scores in the two groups were significantly lower than those before treatment (t=15.19, 12.83, 8.66, 15.76, all P<0.01), And the score of the study group was significantly lower than that of the control group (t=2.29, 2.50, P=0.03, 0.02). Conclusion The iTBS mode rTMS can significantly reduce depression and self-injury levels in adolescent depression patients with non-suicidal self-injury behavior, which is safe and effective.
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