中文摘要：

目的探讨重复经颅磁刺激（rTMS）联合文拉法辛缓释胶囊治疗对老年抑郁症的临床疗效及安全性。方法选取2015年1月至2016年12月在该科住院的符合老年抑郁症诊断标准的患者52例,随机分为研究组和对照组,各26例。研究组患者采用rTMS联合文拉法辛缓释胶囊（75~225 mg/d）治疗,对照组患者采用文拉法辛缓释胶囊（75~225 mg/d）联合伪刺激治疗。两组患者连续观察4周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）比较两组患者在治疗前,治疗2、4周末的疗效及临床安全性。结果两组患者在治疗2、4周末HAMD、HAMA评分均较治疗前有所降低,差异均有统计学意义（P〈0.05）。治疗2、4周末时两组治疗总有效率比较,差异均有统计学意义（P〈0.05）;两组患者文拉法辛缓释胶囊平均使用剂量、不良反应发生率比较,差异均无统计学意义（P〉0.05）。结论 rTMS联合文拉法辛缓释胶囊较单一文拉法辛缓释胶囊治疗老年抑郁症效果更优,能较快改善患者的抑郁焦虑情绪,且不良反应少,安全性较高。

英文摘要：

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation（rTMS）combined with venlafaxine sustained-release capsules in the treatment of senile depression. Methods A total of 52 patients,who met the Diagnostic Criteria for Geriatric Depression in the department from January 2015 to December 2016,were selected and divided into the research group and the control group,26 cases in each group. The research group was treated with rTMS combined with venlafaxine sustained-release capsules（75-225 mg/d）,while the control group was treated with venlafaxine sustained-release capsules（75-225 mg/d） combined with sham-stimulation. Both groups received continuous observation for 4 weeks.The Hamilton Depression Scale（HAMD） and Hamilton Anxiety Scale（HAMA） were adopted to compare the clinical efficacy and safety in the two groups before treatment and 2,4 weeks after treatment. Results At the end of 2nd,4th week after treatment,the scores of HAMD and HAMA in both groups decreased more obviously than those before treatment with statistically significant dif-ference（P〈0.05）;the difference of total effective rate at the end of 2nd,4th week between the two groups had statistical signifi cance（P〈0.05）;the rate of adverse reaction and average dose of venlafaxine sustained-release capsules between the two groups showed no statistically significant difference（P〉0.05）. Conclusion The combination of rTMS and venlafaxine sustained-release capsules is better than venlafaxine sustained-release capsules in the treatment of senile depression,the former can quickly improve the depression and anxiety with less adverse reaction and higher safety.