强光疗法辅助治疗非季节性抑郁症患者的临床疗效
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国家自然科学基金项目(81771463);河北省医学科学研究项目(20130578)


Clinical efficacy of bright light therapy as an adjunctive therapy for non-seasonal depressive disorder patients
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    摘要:

    目的 探讨在药物治疗的基础上采用强光疗法(BLT)辅助治疗非季节性抑郁症的临床效 果。方法 选取2020年9月至2021年1月于河北医科大学第一医院精神卫生中心住院的33例非季节性 抑郁症患者为研究对象。根据随机数字表法分为 BLT 组(17 例)和暗光组(16 例),在药物治疗的基础上 于清晨分别给予为期 2 周的 BLT 辅助治疗和暗光治疗。比较治疗前及治疗第 2 周末两组 17 项汉密尔顿 抑郁量表(HAMD-17)评分、临床总体印象量表(CGI)评分;比较治疗前及治疗第 1 周末两组 16 项抑郁症 症状快速自评量表(QIDS-SR16)评分;比较两组患者治疗第 2 周末临床反应率,并评估治疗起效时间。 结果 BLT 组、暗光组分别有 15 例、12 例患者完成本研究,其中 BLT 组中度抑郁症患者 7 例,重度抑郁 症患者 8 例;暗光组中度抑郁症患者 7 例,重度抑郁症患者 5 例。治疗前 BLT 组认知障碍因子评分高于 暗光组[2.00(1.67,2.00)分比 1.33(0.75,1.90)分],差异有统计学意义(Z=-2.777,P< 0.01)。治疗第 2 周 末,BLT 组 HAMD-17 总分、焦虑 / 躯体化因子评分、疾病严重程度评分均低于暗光组[(9.40±4.15)分比 (13.75±5.61)分、(0.56±0.38)分比(1.00±0.53)分、2.00(1.00,3.00)分比 3.00(3.00,4.00)分],差异均有 统计学意义(P< 0.05)。BLT 组认知障碍因子评分的治疗前后变化值高于暗光组[1.31(1.00,1.34)分比 0.33(0,1.17)分],差异有统计学意义(Z=-2.680,P< 0.01)。BLT 组的临床反应率为 8/15,与暗光组的 4/12 比较,差异无统计学意义(P> 0.05)。BLT 组治疗平均起效时间为 5.14 d,暗光组未发现 1 周内起 效情况。结论 BLT 辅助治疗能够快速、有效地改善非季节性抑郁症患者的抑郁症状并降低疾病严重 程度。

    Abstract:

    Objective To explore the efficacy of bright light therapy (BLT) as an adjunctive therapy for non-seasonal depressive disorder on the basis on drug treatment. Methods A total of 33 patients with non-seasonal depression hospitalized in the Mental Health Center of the First Hospital of Hebei Medical University from September 2020 to January 2021 were selected as the research subjects. According to the random number table method, they were divided into BLT group (17 patients) and dim light therapy group (16 patients). Based on drug treatment, BLT adjuvant treatment and dim light treatment were given in the morning for 2 weeks. The scores of 17-item Hamilton Depression Scale (HAMD-17) and Clinical Global Impression (CGI) were compared between the two groups before treatment and at the end of the second week of the treatment; The scores of 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16) were compared between the two groups before treatment and at the end of the first week of treatment. The clinical response rate of the two groups at the end of the second week of treatment was compared, and the onset time of treatment was evaluated. Results 15 participants in the BLT group and 12 participants in the dim light therapy group completed this study. There were 7 patients with moderate depression and 8 patients with major depression in the BLT group, 7 patients with moderate depression and 5 patients with major depression in the dim light therapy group. Before the treatment, the score of cognitive impairment factor in BLT group was higher than that in dim light therapy group [2.00(1.67,2.00) vs 1.33(0.75,1.90)], and the difference is statistically significant (Z= -2.777,P< 0.01). At the end of the second week of treatment, the total HAMD-17 score, anxiety somatization factor score, and disease severity score were statistically significantly lower in the BLT group than those in the dim light therapy group [(9.40±4.15) vs (13.75±5.61), (0.56±0.38) vs (1.00±0.53) and 2.00(1.00,3.00) vs 3.00(3.00,4.00); P < 0.05]. The change of cognitive impairment factor scores before and after treatment in the BLT group was higher than that in the dim light therapy group [1.31(1.00,1.34) vs 0.33(0,1.17)]. The difference was statistically significant (Z=-2.680, P< 0.01). The clinical response rate of BLT group was 8/15, which compared with 4/12 of the dim light therapy group, showing no statistically significant difference (P > 0.05). The onset time of treatment was 5.14 days in the BLT group. No effect was found within 1 week in the dim light therapy group. Conclusions BLT, as an adjunctive therapy, can improve depressive symptoms and reduce disease severity quickly and effectively for patients with non-seasonal depressive disorder.

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翟璇,孙亚麒,王子扬,王永良,苏昱,乔晓岭,王育梅,孙惠铭,王学义.强光疗法辅助治疗非季节性抑郁症患者的临床疗效[J].神经疾病与精神卫生,2022,22(8):
DOI :10.3969/j. issn.1009-6574.2022.08.001.

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  • 在线发布日期: 2022-08-23