rTMS联合舍曲林对成人抑郁症伴NSSI的影响OA

Objective:To observe the influence of treatment regimen of Sertraline combined with repetitive transcranial magnetic stimulation(rTMS)on adult depressive disorder(DD)with non-suicidal self-injury(NSSI).Method:A total of 70 patients with adult DD with NSSI who were treated in the Third People's Hospital of Yichun from January 1,2023 to December 31,2024 were enrolled as research subjects,and were divided into the study group(n=35)and control group(n=35)by random number table method.The control group was treated with Sertraline Hydrochloride orally,and the study group was combined with rTMS on this basis.After 4 weeks of treatment,the clinical efficacy was assessed in the two groups.The negative emotions,impulsive behavior,neurotransmitters levels,neurological function indexes and quality of life before treatment and after 4 weeks of treatment were compared between the two groups.The occurrence of adverse reactions in the two groups of patients during treatment was counted.Result:After 4 weeks of treatment,the total effective rate in the study group(94.29%)was higher than that in the control group(77.14%)(P<0.05).After 4 weeks of treatment,the scores of HAMD-17,HAMA and Barratt impulsiveness scale(BIS-11)in both groups were decreased compared to those before treatment,and the scores of all these items in the study group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the levels of norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),melatonin(MT),and glial cell-derived neurotrophic factor(GDNF)in both groups were higher than those before treatment,the levels of NE,DA,5-HT,BDNF,MT and GDNF in the study group were higher than those in the control group(P<0.05).After 4 weeks of treatment,the scores of each dimension of the general quality of life inventory-74(GQOLI-74)in both groups increased compared to those before treatment,those of the study group were higher than those of the control group(P<0.05).No statistical difference was found in the total incidence rate of adverse reactions between the study group(20.00%)and the control group(14.29%)(P>0.05).Conclusion:rTMS combined with Sertraline can alleviate the negative emotions of patients with adult DD and NSSI,reduce impulsive behavior,enhance the expression of neurotransmitters,and improve quality of life,and has a higher clinical efficacy without increasing adverse reactions.