标题：经颅微电流刺激联合本森放松技术在首发抑郁症患者中的临床应用

      作者：吕有良，朱俊芳，王芳，蔡莹莹，郝以辉    郑州大学第一附属医院精神医学科，河南 郑州 450000

      卷次： 2024年35卷8期

      【摘要】 目的 探讨经颅微电流刺激(CES)联合本森放松技术(BRT)对首发抑郁症患者神经递质、抑郁及躯体化症状的调控作用。方法 选取2022年6月至2023年3月郑州大学第一附属医院精神医学科收治的108例首发抑郁症患者纳入研究，按随机数表法分为观察组、对照1组和对照2组，每组36例。所有患者均采取常规药物治疗，于此基础上对照1组采取CES治疗，对照2组采取BRT治疗，观察组患者采取CES联合BRT治疗，连续治疗8周。比较三组患者治疗前、治疗4周、8周后的神经递质[5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)]水平、重复性成套神经心理状态测试(RBANS)、汉密尔顿抑郁量表(HAMD)、自杀意念量表(BSI-CV)及躯体症状群量表(PHQ-15)评分。结果 治疗前，三组患者的神经递质水平比较差异均无统计学意义(P>0.05)；治疗4周、8周后，三组患者的神经递质水平呈逐渐升高趋势，且治疗4周、8周后，观察组患者的血清5-HT、DA、NE水平>对照1组>对照2组，差异均有统计学意义(P<0.05)。治疗前和治疗4周后，三组患者的认知功能水平比较差异均无统计学意义(P>0.05)；治疗4周、8周后，三组患者的认知功能评分呈逐渐升高趋势，且治疗8周后，观察组患者的认知功能评分>对照1组>对照2组，差异均有统计学意义(P<0.05)。治疗前，三组患者的HAMD、BSI-CV评分比较差异均无统计学意义(P>0.05)；治疗 4周、8周后，三组患者的HAMD、BSI-CV评分呈逐渐降低趋势，且治疗 4周、8周后，观察组患者的HAMD、BSI-CV评分<对照2组<对照1组，差异均有统计学意义(P<0.05)。治疗前，三组患者的PHQ-15评分比较差异均无统计学意义(P>0.05)；治疗4周、8周后，三组患者的PHQ-15评分呈逐渐降低趋势，且治疗4周、8周后，观察组患者的PHQ-15评分低于对照1组和对照2组，差异均有统计学意义(P<0.05)，但对照1组和对照2组间比较差异均无统计学意义(P>0.05)。结论 CES联合BRT应用于首发抑郁症患者可发挥协同作用，有助于改善患者神经递质水平，减轻抑郁及躯体化症状，降低自杀意念。
      【关键词】 抑郁症；经颅微电流刺激；本森放松技术；神经递质；躯体化症状；认知功能
      【中图分类号】 R749.4 【文献标识码】 A 【文章编号】 1003—6350（2024）08—1096—06

Clinical application of cranial electrotherapy stimulation combined with Benson's relaxation technique inpatients with first-episode depression.
LV You-liang, ZHU Jun-fang, WANG Fang, CAI Ying-ying, HAO Yi-hui.Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To investigate the regulatory effect of cranial electrotherapy stimulation (CES) com-bined with Benson's relaxation technique (BRT) on neurotransmitters, depression, and somatic symptoms in patientswith first-episode depression. Methods A total of 108 patients with first-episode depression admitted to the Depart-ment of Psychiatry, the First Affiliated Hospital of Zhengzhou University from June 2022 to March 2023 were select-ed for inclusion in the study. They were randomly divided into an observation group, a control group 1, and a controlgroup 2, with 36 patients in each group. All patients received conventional drug treatment. On this basis, the controlgroup 1 received CES treatment, the control group 2 received BRT treatment, and the observation group received CEScombined with BRT treatment, continuously for 8 weeks. The levels of neurotransmitters [5-hydroxytryptamine (5-HT),dopamine (DA), noradrenaline (NE)], the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS), the Hamilton Depression Scale (HAMD), Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), andthe Patient Health Questionnaire (PHQ-15) scores before treatment, after 4 weeks treatment, and after 8 weeks of treat-ment were compared among the three groups. Results Before treatment, there was no significant difference in neu-rotransmitter levels among the three groups (P>0.05). After 4 and 8 weeks of treatment, the levels of neurotransmitters inthe three groups showed a gradually increasing trend, and after 4 and 8 weeks of treatment, the levels of serum 5-HT,DA, and NE in the observation group were significantly higher than those in the control group 1 and control group 2, andthe differences were statistically significant (P<0.05). Before treatment and after 4 weeks of treatment, there was no sig-nificant difference in the level of cognitive function among the three groups (P>0.05). After 4 weeks and 8 weeks oftreatment, the cognitive function scores of the three groups showed a gradual increasing trend, and after 8 weeks of treat-ment, the cognitive function scores decreased successively in the observation group, the control group 1, and controlgroup 2 (P<0.05). Before treatment, there was no significant difference in HAMD and BSI-CV scores among the threegroups (P>0.05). After 4 weeks and 8 weeks of treatment, the HAMD and BSI-CV scores of the three groups showed adecreasing trend, and after 4 weeks and 8 weeks of treatment, the HAMD and BSI-CV scores increased successively inthe observation group, the control group 2, and the control group 1 (P<0.05). Before treatment, there was no significantdifference in PHQ-15 score among the three groups (P>0.05). After 4 and 8 weeks of treatment, the PHQ-15 scores ofthe three groups gradually decreased, and after 4 weeks and 8 weeks of treatment, the PHQ-15 scores of the observationgroup were lower than those of the control group 1 and the control group 2 (P<0.05), with no statistically significant dif-ference between the control group 1 and the control group 2 (P>0.05). Conclusion The application of CES combinedwith BRT in patients with first-episode depression can play a synergistic role, help to improve the level of neurotransmit-ters in patients, reduce depression and somatization symptoms, and reduce suicidal ideation.
      【Key words】 Depression; Cranial electrotherapy stimulation; Benson's relaxation technique; Neurotransmitter;Somatic symptoms; Cognitive function