| Objective:To explore the clinical study of post-stroke depression with combined REC combined with repeated transcranial magnetic stimulation.Methods:Select time period 2018.11.1-2020.1.31 to visit the Department of Neurology of Yan'an University Affiliated Hospital and were diagnosed as PSD patients.According to the inclusion and exclusion criteria,237 samples were selected,and 216patients were randomly selected as experimental group experimental group using STATAT software sampling program,and the remaining 108 cases as control group.experimental group was given the oral drug escitalopram oxalate(Escitalopram oxalate EO 10 mg once a day)combined with repeated transcranial magnetic stimulation(Repetitive cranial magnetic stimulation rTMS)(1200 pulses per left temporal lobe,right temporal 600 pulses per leaf,1800 pulses on the left and right sides,20 minutes/day on each side,once a day)for a total of four weeks,and then the baseline depression level,the Hamilton Depression Scale on the first,second and fourth weekend,Depression Self-rating Scale and Montgomery Depression Rating Scale,and statistical analysis of each score value;Administer EO(10 mg once a day)for four weeks,and measure the above-mentioned depression score scales at baseline,the first,second,and fourth weekends for statistical analysis.Results:At the experimental group inning of this study,216 samples were obtained.Ten patients,six experimental groups and four control groups were withdrawn due to patients'intolerance to treatment or excessive financial burden or death and other special reasons.Finally,206 cases,102 cases of experimental group and 104 cases of control group were included in the study.All data in this experiment were analyzed by STATA15.0 software.The results of this experiment have the followingpoints:1.General information of experimental group and control group p>0.05,no statistical significance;2.The two sets of experimental data are verified by the STATA software program to meet the normal distribution;3.Statistical analysis main effect:baseline level before HAMD treatment(t=0.162595%CI 19.572~20.524 p=0.8711),the two groups of trials have no statistical significance,after four weeks of combined treatment(t=-5.2590 95%CI-3.699~-1.673p=0.0000),the scores of the two groups are statistically significant;4.Statistical analysis of secondary effects:SDS baseline level(t=-1.5694 95%CI60.938~62.342 p=0.1181),no statistical significance between the two groups of trials,at the fourth weekend(t=-5.8132 95%CI 50.220~51.915 p=0.0000),the score scores of the two groups are statistically significant;the baseline level of MADRS(t=0.1497 95%CI-1.200~1.397 p=0.8812),the two groups of trials have no statistical significance,at the fourth weekend(t=-2.7789 95%CI 13.057~14.201 p=0.0060),the scores of the two groups are statistically significant;5.Statistical efficiency:Analysis of the curative effect of the two groups based on the percentage reduction of HAMD,and the overall overall effective rate of experimental group and control group(92.2%77.0%%c~2=9.107878 p=0.002545);6.Statistics of the occurrence of adverse reactions:experimental group is mainly highlighted by head discomfort and dizziness,and control group is more nausea,vomiting and other stomach discomfort and fatigue,but the overall response is good.After symptomatic treatment of the above two groups,the symptoms eased or disappeared,and the experiment was completed.The total adverse reaction rate of experimental group and control group(12%and 13%c~2=0.026110 p=0.871632).The results of the two groups have no statistical significance.Conclusion:1.Compared with the control group,the score reduction ratios of HAMD,SDS,and MADRS in the experimental group are larger,indicating that the combined treatment of the two is beneficial to PSD improvement to a certain extent.2.Compared with the control group,the total EE in the experimental group was significantly higher,suggesting that EO combined with rTMS had a significant effect on PSD;3.The adverse reactions were slightly different between the two groups,but there was no significant difference in the total IAR between the experimental group and control group;4.Overall,EO combined with rTMS has outstanding improvement in mood disorders,neurological rehabilitation and social adaptability of PSD patients,which has a certain reference significance for medical workers to treat the disease.However,in view of the small sample size and inevitable biases in information and statistics,the test results still need to be further verified to support the evidence from the perspective of medical confirmation. |
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