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目的:观察不同频次无抽搐电休克（MECT）治疗对抑郁障碍患者的疗效及认知功能、近红外脑功能成像（fNRIS）的影响。方法:回顾性选取2022年12月至2023年7月湖州市第三人民医院收治的抑郁障碍患者60例的临床资料，采用病例对照研究，根据治疗方式不同分为治疗1组、治疗2组与治疗3组，每组20例，三组患者均接受常规抗抑郁药物治疗，其中治疗1组在常规治疗基础上接受6次MECT治疗，治疗2组为8次MECT治疗，治疗3组为10次MECT治疗，三组患者治疗时间均为4周。比较三组患者治疗前后的汉密尔顿抑郁评分（HAMD-24）、汉密尔顿焦虑评分（HAMA-14）、临床疗效（CGI）评分、简易智力状态（MMSE）评分、威斯康星卡片分类测验（WCST）评分、连线测验A（TMTA）评分、连线测验B（TMTB）评分、数字符号转换测验（DSST）评分，统计患者治疗期间出现的不良反应，并采用副反应量表（TESS）评估药物不良反应发生情况；另外于治疗前后采用fNRIS在言语流畅性任务（VFT）下评估患者的认知功能。结果:治疗1周、2周及4周，治疗2组与治疗3组HAMD-24、HAMA-14及CGI评分均低于治疗1组，差异均有统计学意义（ F组间=32.09， F时间=54.27， F交互=7.53，均 P < 0.05），（ F组间=38.14， F时间=69.33， F交互=8.59，均 P < 0.05），（ F组间=11.22， F时间=28.29， F交互=9.14，均 P < 0.05）；治疗1组与治疗2组MMSE、WCST及DSST评分均高于治疗3组，TMTA、TMTB评分均低于治疗3组，差异均有统计学意义（ F组间=14.20， F时间=44.27， F交互=6.24，均 P < 0.05），（ F组间=18.23， F时间=67.15， F交互=8.54，均 P < 0.05），（ F组间=9.30， F时间=75.16， F交互=9.41，均 P < 0.05），（ F组间=19.47， F时间=85.76， F交互=9.33，均 P < 0.05），（ F组间=22.26， F时间=46.37， F交互=6.52，均 P < 0.05）。三组不良反应发生率比较，差异无统计学意义（ F组间=3.03， F时间=8.36， F交互=1.25，均 P > 0.05）。治疗4周后治疗2组患者VFT下组词个数及oxy-Hb水平均高于治疗1组与治疗3组，差异均有统计学意义（ F=29.71，198.57，均 P < 0.05）。 结论:MECT应用于抑郁障碍患者的临床疗效肯定，安全性较高，其中4周内接受8次MECT的抑郁障碍患者临床疗效较好，且认知功能及fNRIS改善情况更佳。

Objective:To investigate the efficacy of different frequencies of modified electroconvulsive therapy in patients with depressive disorder and its effect on cognitive function and functional near infrared spectroscopy.Methods:The clinical data from 60 patients with depressive disorder, admitted to The Third People's Hospital of Huzhou between December 2022 and July 2023, were retrospectively analyzed. This study was designed as a case-control study. These patients were divided into three treatment groups according to different treatment methods: Group 1 ( n = 20), Group 2 ( n = 20), and Group 3 ( n = 20). All patients underwent conventional antidepressant therapy. Additionally, Group 1 received six sessions of modified electroconvulsive therapy, Group 2 received eight sessions, and Group 3 received ten sessions. The treatment duration for all groups was 4 weeks. Comparisons were made among the three groups for pre- and post-treatment scores on the 24-item Hamilton Depression Rating Scale, 14-item Hamilton Anxiety Rating Scale, Clinical Global Impression Scale, Mini-Mental State Examination, Wisconsin Card Sorting Test, Trail Making Test Part A (TMT-A), Trail Making Test Part B (TMT-B), and Digit Symbol Substitution Test. Furthermore, the incidence of adverse reactions during treatment was calculated, and the Treatment Emergent Symptom Scale was used to assess the occurrence of adverse drug reactions. Moreover, functional Near-Infrared Spectroscopy was used before and after treatment to evaluate the cognitive function of patients under the Verbal Fluency Task. Results:At 1, 2, and 4 weeks of treatment, the 24-item Hamilton Depression Rating Scale, 14-item Hamilton Anxiety Rating Scale, and Clinical Global Impression Scale scores of Group 2 and Group 3 were significantly lower than those of Group 1 ( Finter-group = 32.09, Ftime = 54.27, Finteraction = 7.53, all P < 0.05; Finter-group = 38.14, Ftime = 69.33, Finteraction = 8.59, all P < 0.05; Finter-group = 11.22, Ftime = 28.29, Finteraction = 9.14, all P < 0.05). The Mini-Mental State Examination, Wisconsin Card Sorting Test, and Digit Symbol Substitution Test scores of Group 1 and Group 2 were significantly higher than those of Group 3, while Trail Making Test Part A and Trail Making Test Part B scores of Group 1 and Group 2 were significantly lower than those of Group 3 ( Finter-group = 14.20, Ftime = 44.27, Finteraction = 6.24, all P < 0.05; Finter-group = 18.23, Ftime = 67.15, Finteraction = 8.54, all P < 0.05; Finter-group = 9.30, Ftime = 75.16, Finteraction = 9.41, all P < 0.05; Finter-group = 19.47, Ftime = 85.76, Finteraction = 9.33, all P < 0.05; Finter-group = 22.26, Ftime = 46.37, Finteraction = 6.52, all P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups ( Finter-group = 3.03, Ftime = 8.36, Finteraction = 1.25, all P > 0.05). After 4 weeks of treatment, the number of Verbal Fluency Task words and oxy-Hb level in Group 2 were significantly higher compared with those in Group 1 and Group 3 ( F = 29.71, 198.57, both P < 0.05). Conclusion:Modified electroconvulsive therapy is highly effective and safe in treating depressive disorders in patients. Eight sessions of modified electroconvulsive therapy administered within 4 weeks have been shown to exhibit better clinical efficacy and lead to greater improvements in cognitive function and functional near-infrared spectroscopy measurements compared with six or ten sessions of treatment.