Abstract：Objective: To investigate the clinical efficacy of repeated transcranial magnetic stimulation (rTMS) combined with sertraline in the treatment of refractory obsessive-compulsive disorder. Methods: A total of 82 patients with refractory obsessive-compulsive disorder from May 20 to May 2017 were enrolled in this study. All the patients were randomly divided into observation group and control group, 41 cases in each group. The control group was treated with sertraline alone, while the observation group was treated with rTMS on the basis of the control group for 2 months. The Chinese version of Yale-Brown obsessive-compulsive symptoms scale (Y-BOCS) and Hamilton anxiety scale (HAMA) were used to evaluate the degree of obsessive-compulsive disorder symptoms and anxiety of the two groups before and after treatment for 2, 4, 6 and 8 weeks, respectively. The clinical therapeutic effects of the two groups were compared. The adverse reactions were assessed by the side effects scale (TESS). Results: The levels of Y-BOCS and HAMA in the observation group after treatment were significantly lower than those before treatment (P<0.05), and the control group except the first 2 weeks and before treatment was not obvious difference, but 4, 6, 8 weeks and before treatment was significantly obvious difference (P<0.05). The scores of Y-BOCS, HAMA and HAMA at the 4th, 6th and 8th week after treatment were significantly better than those of the control group at the 2nd, 4th, 6th and 8th week after treatment (P<0.05). After 8 weeks of treatment, the total effective rate was 95.1% in the observation group was significantly better than the control group of 70.7%, the two groups of patients with blood and urine routine examination and liver and kidney function tests, ECG were not found abnormal, TESS score was not significant (P>0.05). Conclusion: For patients with refractory obsessive-compulsive disorder, rTMS stimulation combined with sertraline can effectively improve the obsessive-compulsive symptoms and anxiety of patients. The clinical efficacy is remarkable, the adverse reactions are small, and the safety is high. It is worthy of clinical application.
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2019, Vol. 25 
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