舍曲林联合重复经颅磁刺激对老年2型糖尿病患者伴抑郁的疗效观察Effect of sertraline combined with repetitive transcranial magnetic stimulation on depression in elderly patients with type 2 diabetes mellitus
李素军;李伟芳;杨磊;李媛媛;
摘要(Abstract):
目的观察舍曲林联合重复经颅磁刺激(rTMS)对老年2型糖尿病伴抑郁患者的治疗效果。方法选择2017-05—2020-08郑州大学第一附属医院老年内分泌科老年2型糖尿病伴抑郁患者120例,根据抛硬币法随机分为舍曲林联合重复经颅磁刺激组(联合组)和舍曲林单药治疗组(单药组)各60例,观察8周,联合组随访到53例,单药组随访到54例。对比2组治疗前后抗抑郁治疗有效率、汉密顿抑郁量表(HAMD-17)评分、服药依从性量表(MMAS-8)评分、中文版老年糖尿病自我管理行为量表(DSMB-O)评分和副反应量表(TESS)评分。结果治疗后2组有效率、MMSA-8、DSMB-O评分均随治疗时间的延长而增加,联合组增加幅度高于单药组,差异均有统计学意义(P<0.05)。治疗后2组HAMD-17评分均随治疗时间的延长而下降,联合组下降幅度高于单药组,差异均有统计学意义(P<0.05)。治疗后2组TESS评分差异无统计学意义(P>0.05)。结论 rTMS能够增强舍曲林对老年2型糖尿病伴抑郁患者的抗抑郁效果,同时能够增加患者的服药依从性和自我管理能力。
关键词(KeyWords): 抑郁症;2型糖尿病;老年;重复经颅磁刺激;舍曲林
基金项目(Foundation): 河南省重大公益性项目[编号:HNZB(2010)N91号]
作者(Authors): 李素军;李伟芳;杨磊;李媛媛;
参考文献(References):
- [1]LI S,YIN C,ZHAO W,et al.Application of Hydrogen Proton Magnetic Resonance Technology Combined with Brain Neurometabolite Analysis in the Treatment of Cognitive Impairment Caused by Type 2 Diabetes Mellitus[J].World Neurosurg,2020,138(1):654-662.DOI:10.1016/j.wneu.2019.12.162.
- [2]BRAGG F,HOLMES M V,IONA A,et al.Association Between Diabetes and Cause-Specific Mortality in Rural and Urban Areas of China[J].JAMA,2017,317(3):280-289.DOI:10.1001/jama.2016.19720.
- [3]XIAO F,LIU M,WANG X F.Involuntary choreiform movements in a diabetic patient[J].Lancet,2019,393(10175):1033.DOI:10.1016/S0140-6736(19)30304-6.
- [4]SUN C,LI X,SONG B,et al.A NADE nomogram to predict the probability of 6-month unfavorable outcome in Chinese patients with ischemic stroke[J].BMC Neurol,2019,19(1):274.DOI:10.1186/s12883-019-1464-6.
- [5]MENDENHALL E,KOHRT B A,NORRIS S A,et al.Non-communicable disease syndemics:poverty,depression,and diabetes among low-income populations[J].Lancet,2017,389(10072):951-963.DOI:10.1016/S0140-6736(17)30402-6.
- [6]HANYU H.Diabetes-Related Dementia[J].Adv Exp Med BIOL,2019,1128:147-160.DOI:10.1007/978-981-13-3540-2-8.
- [7]LY H,VERMA N,WU F,et al.Brain microvascular injury and white matter disease provoked by diabetes-associated hyperamylinemia[J].Ann Neurol,2017,82(2):208-222.DOI:10.1002/ANA.24992.
- [8]MARTINY K.Novel Augmentation Strategies in Major Depression[J].Dan Med J,2017,64(4):B5338.
- [9]MCCLINTOCK S M,RETI I M,CARPENTER L L,et al.Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation(rT-MS)in the Treatment of Depression[J].J Clin Psychiatry,2018,79(1):16cs10905.DOI:10.4088/JCP.16cs10905.
- [10]POP-BUSUI R,BOULTON A J,FELDMAN E L,et al.Diabetic neuropathy:a neuropathy:a position statement by the A-merican Diabetes Association[J].Diabetes Care,2017,40(1):136-154.DOI:10.2337/dc16-2042.
- [11]KESMODEL S B,GOLOUBEVA O G,ROSENBLATTP Y,et al.Patient-reported Adherence to Adjuvant Aromatase Inhibitor Therapy Using the Morisky Medication Adherence Scale An Evaluation of Predictors[J].Am J Clin Oncol,2018,41(5):508-512.DOI:10.1097/COC.0000000000000314.
- [12]GONCALVES N P,VAEGTER C B,ANERSEN H,et al.Schwann cell interactions with axons and microvessels in diabeticneuropathy[J].Nat Rev Neurol,2017,13(3):135-147.DOI:10.1038/nrneurol.2016.201.
- [13]DOUVEN E,KOHLER S,RODRLGUEZ M M F,et al.Imaging Markers of Post-Stroke Depression and Apathy:a Systematic Review and Meta-Analysis[J].Neuropsychol Rev,2017,27(3):202-219.DOI:10.1007/s11065-017-9356-2.
- [14]SEO K,SONG M,CHOI S,et al.Development of a scale to measure diabetes self-management behaviors among older Koreans with type 2 diabetes,based on the seven domains identified by the American Association of Diabetes Educators[J].Jap J Nurs Sci,2017,14(2):161-170.DOI:10.1111/jjns.12145.
- [15]YUE H,ZHOU S,WU H,et al.Efficacy and safety of electro-acupuncture(EA)on insomnia in patients with lung cancer:study protocol of a randomized controlled trial[J].Trials,2020,21(1):788.DOI:10.1186/s13063-020-04721-4.
- [16]ZHANG L,LI M,SUI R.Correlation between cerebellar metabolism and post-stroke depressio in patients with ischemic stroke[J].Oncotarget,2017,19,8(53):91711-91722.DOI:10.18632/ONCOTARGET.21063.
- [17]SHARRIEF A Z,SANCHEZ B N,LISABETH L D,et al.The Impact of Pre-Stroke Depressive Sympsoms,Fatalism,and Social Support on Disability after Stroke[J].JStroke Cerebrovasc Dis,2017,26(11):2686-2691.DOI:10.1016/j.jstrokecerebrovasdis.2017.06.039.
- [18]谭西英,王宇,李欣,等.2型糖尿病中枢神经损伤的1H-MRS研究[J].中国实用神经疾病杂志,2020,23(21):1866-187.DOI:10.12083/SYSJ.2021.01.012.
- [19]CROARKIN P E,MACMASTER F P.Transcranial Magnetic Stimulation for Adolescent Depression[J].Child Adolesc Psychiatr Clin N Am,2019,28(1):33-43.DOI:10.1016/j.chc.2018.07.003.
- [20]ANDRIOTTI T,STAVALE R,NAFEE T,et al.AS-SERT trial-How to assess the safety and efficacy of a high frequency r TMS in postpartum depression?Amulticenter,double blinded,randomized,placebo-controlled clinical trial[J].Contemp Clin Trials Commun,2017,5:86-91.DOI:10.1016/J.CONCTC.2017/01.004.
- [21]TAYLOR R,GALVEZ V,LOO C.Transcranial magnetic stimulation(TMS)safety:a practical guide for psychiatrists[J].Australas Psychiatry,2018,26(2):189-192.DOI:10.1177/1039856217748249.
- [22]CHANG H C,CHANG Y C,LEE S M,et al.The effectiveness of hospital-based diabetes case management:an example from a northern Taiwan regional hospital[J].J Nurs Res,2007,15(4):296-309.DOI:10.1097/01.jnr.0000387626.48672.b1.
- [23]KERR M,MILLER J J,THAPA D,et al.Rescue of myocardial energetic dysfunction in diabetes through the correction of mitochondrial hyperacetylation by honokiol[J].JCI Insight,2020,5(17):e140326.DOI:10.1172/jci.insight.140326.
- [24]刘春林,郭志勇.磁共振弥散张量成像在2型糖尿病患者脑白质损伤中的应用研究进展[J].中国实用神经疾病杂志,2019,22(6):586-590.DOI:10.12083/SYSJ.2019.06.255.
- [25]VOLZ M,LADWIG S,WERHEID K.Gender differences in post-stroke depression:A longitudinal analysis of prevalence,persistence and predictive value of known risk factors[J].Neuropsychol Rehabil,2019,5:1-17.DOI:10.1080/09602011.2019.1648301.
- [26]OROZCO MORALES J A,MEDINA URRUTIA A X,TORRES TAMAYO M,et al.Effects of fatty liver on the size and composition of high-density lipoprotein cholesterol subpopulations in adolescents with type 2 diabetes mellitus[J].Prediatr Diabetes,2020,21(7):1140-1149.DOI:10.1111/pedi.13103.