摘要
目的 经颅直流电刺激术（tDCS）对抑郁症伴自杀意念患者的增效及安全性。方法 纳入60例2024年5月-2026年5月患者医院收治的伴自杀意念抑郁症患者，以随机数字表法分研究组与对照组各30例，均予舍曲林常规干预，研究组加用tDCS，对照组予伪tDCS，干预周期4周。于基线、1、2、4周末，采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、积极与消极自杀意念量表（PANSI）、治疗时出现的症状量表（副反应量表）（TESS）评估。结果 4周后两组上述三项量表评分均较基线显著下降（P<0.05），研究组（HAMD 12.4±3.5分、HAMA 8.6±2.4分、PANSI 16.2±3.8分）优于对照组（19.7±4.2分、13.5±3.1分、26.5±4.6分）；研究组总有效率86.67%、不良反应率6.67%，均优于对照组（60.00%、23.33%），差异均有统计学意义（P<0.05）。结论 经颅直流电刺激术方案增效显著、安全性高，具临床推广价值。
关键词： 经颅直流电刺激；抑郁症；自杀意念；增效治疗；舍曲林
Abstract
Objective To explore the enhancing effect and safety of transcranial direct current stimulation (tDCS) in patients with depression accompanied by suicidal ideation. Methods A total of 60 patients with depressive disorder accompanied by suicidal ideation who were admitted to the hospital from May 2024 to May 2026 were included. They were randomly divided into the study group and the control group, with 30 cases in each group. Both groups received conventional sertraline intervention. The study group was additionally treated with tDCS, while the control group received sham tDCS. The intervention period was 4 weeks. At baseline, 1 week, 2 weeks, and 4 weeks later, the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Suicidal Ideation Scale (PANSI), and Treatment-Emergent Symptom Scale (adverse reaction scale) (TESS) were used for assessment. Results After 4 weeks, scores on the above three scales in both groups significantly decreased compared to baseline (P<0.05), with the study group (HAMD 12.4±3.5, HAMA 8.6±2.4, PANSI 16.2±3.8) performing better than the control group (19.7±4.2, 13.5±3.1, 26.5±4.6). The total effective rate in the study group was 86.67% and the adverse reaction rate was 6.67%, both superior to the control group (60.00%, 23.33%), with statistically significant differences (P<0.05). Conclusion The tDCS protocol shows significant enhancing effects and high safety, and has clinical promotion value.
Key words： Transcranial direct current stimulation; Depression; Suicidal ideation; Enhancing therapy; Sertraline
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