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目的观察低频经颅磁刺激(rTMS)加认知疗法(CBT)治疗儿童抑郁障碍的疗效。方法将60例儿童抑郁障碍患者分成研究组即rTMS+CBT和对照组即假性刺激+CBT。以上2组均不采用药物治疗。观察2个月,采用儿童抑郁量表(CDI)的变化及差异,观察治疗前及治疗后第2周、第4周、第8周末抑郁情况的变化。结果治疗前即基线时研究组CDI分值(27.03±7.46)分,对照组(27.25±6.93)分,2组CDI分值比较差异无统计学意义(F=0.171,P=0.681)。时间点主效应表明,研究组患者治疗2周时CDI评分[(19.93±5.97)分]较基线降低,与对照组[(25.32±6.53)分]比较差异有统计学意义(F=12.585,P=0.001);治疗4周时研究组CDI评分[(12.17±3.75)分]较基线降低,且低于对照组[(23.39±6.3)分],差异有统计学意义(F=67.027,P=0.000)。经治疗8周后CDI评分[(11.9±3.31)分]明显下降,且显著低于对照组[(17.36±4.57)分],差异有统计学意义(F=30.874,P=0.000)。结论 rTMS联合CBT可有效治疗儿童抑郁障碍,值得临床推广。
Objective To observe the effect of low frequency transcranial magnetic stimulation (rTMS) plus cognitive therapy (CBT) on children with depression. Methods Sixty children with depression were divided into study group (rTMS + CBT) and control group (pseudo-stimulation + CBT). The above two groups do not use drug treatment. Observed for 2 months, the change and difference of Childhood Depression Scale (CDI) were observed, and the changes of depression before and after 2, 4 and 8 weeks after treatment were observed. Results Before treatment, CDI scores of the study group (27.03 ± 7.46) and control group (27.25 ± 6.93), the CDI score of the two groups had no significant difference (F = 0.171, P = 0.681) before treatment. The primary effect at time point showed that the CDI score [(19.93 ± 5.97) points] in the study group was significantly lower than baseline at 2 weeks after treatment, compared with the control group [(25.32 ± 6.53) points] (F = 12.585, P = 0.001). The CDI score of the study group (12.17 ± 3.75) at 4 weeks after treatment was lower than that of the baseline and lower than that of the control group (23.39 ± 6.3), the difference was statistically significant (F = 67.027, P = 0.000). After 8 weeks of treatment, the CDI score [(11.9 ± 3.31) points) was significantly lower than that of the control group [(17.36 ± 4.57) points], the difference was statistically significant (F = 30.874, P = 0.000). Conclusion rTMS combined with CBT can effectively treat depression in children, which is worthy of clinical promotion.