反复经颅磁刺激与有氧运动辅助治疗对抑郁症患者日常生活活动及生活质量影响的比较

Muhammad Yusuf, S. M. Mei Wulan, R. H. Masduchi, Agustina Konginan
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摘要

背景:抑郁症是世界范围内导致残疾和生活质量低下的最常见原因之一。五分之一的患者对抗抑郁药物治疗无效。因此,迫切需要辅助治疗。目的:比较重复经颅磁刺激(rTMS)和有氧运动作为辅助治疗对抑郁症患者日常生活活动和生活质量的影响。材料与方法:2019年5月至2020年1月进行随机对照实验。27名抑郁症患者被分为三组,为期两周:单抗抑郁,抗抑郁+有氧运动,抗抑郁+ rtms。采用Barthel指数和SF-36评估患者的日常生活活动和生活质量。结果:干预后,三组患者Barthel指数评分均无明显变化(p>0.05)。治疗后,SF-36的身体功能、身体不适、公共卫生、活力、社会功能、情感角色功能和心理健康结果在各组间均有显著改善(p < 0.05)。抗抑郁药组和rTMS组患者在整体健康(15.71±6.075,p=0.009)、情绪角色功能(20.29±11.940,p=0.049)和心理健康(14.29±6.075,p=0.041)方面的改善优于其他两组。而Barthel指数评分变化组间差异无统计学意义(p=0.664)。结论:与其他两组相比,rTMS组的生活质量改善更好,支持将rTMS作为附加治疗。旨在提高中重度首发抑郁症患者的生活质量。
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Comparison of the Effects of Repetitive Transcranial Magnetic Stimulation and Aerobic Exercise as an Adjunct Therapy in Depressed Patients on Activity of Daily Living and Quality of Life
Background: Depression is one of the most common causes of disabilities and poor quality of life worldwide. One-fifth of patients fail to respond to antidepressant therapy. Hence, adjunct therapy is urgently needed. Aim: This study aims to compare the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and aerobic exercise as adjunct therapy on activity of daily living and quality of life in depressed patients. Material and Methods: A randomized-controlled experiment was conducted between May 2019 and January 2020. Twenty-seven depressed patients were divided into three groups for two weeks: antidepressant-only, antidepressant-and-aerobic exercise, and antidepressant-and-rTMS. The Barthel Index and SF-36 were used to assess the activity of daily living and quality of life. Results: After the intervention, there were no appreciable changes in the Barthel Index scores in any of the three groups (p>0.05). Following therapy, SF-36 results for physical function, bodily discomfort, public health, vitality, social function, emotional role functioning, and mental health all showed substantial improvements across groups (p 0.05). Patients in the antidepressant and rTMS groups improved more than those in the other two groups in the areas of overall health (15.71±6.075, p=0.009), emotional role functioning (20.29±11.940, p=0.049), and mental health (14.29±6.075, p=0.041). However, the Barthel Index score changes did not differ between groups (p=0.664). Conclusion: Better quality of life improvement in the rTMS group compared to the other two groups supports the use of rTMS as an additional therapy. It aims to enhance quality of life in patients with moderate and severe first-episode depression.
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