低频重复经颅磁刺激治疗原发性失眠症的随机对照研究(1)
[摘要]目的 探讨低频重复经颅磁刺激治疗对原发性失眠症的效果。方法 选取2015年11月～2016年11月就诊于聊城市复退军人医院精神科门诊经诊断为“原发性失眠症”的60例患者作为研究对象，采用随机数字表法将其分为治疗组和对照組，每组各30例。治疗组患者给予rTMS治疗，对照组患者给予假刺激，每周治疗5次，每次20 min，共治疗20次。比较两组患者治疗前和治疗2、4周后的PSQI评分、治疗总有效率及不良反应发生情况。结果 治疗前，两组患者的PSQI评分比较，差异无统计学意义(P>0.05)。治疗2、4周后，两组患者的PSQI评分均低于本组治疗前，且治疗组患者的PSQI评分明显低于对照组，差异均有统计学意义(P<0.01)。治疗组患者的治疗总有效率(96.7%)高于对照组(26.7%)，差异有统计学意义(P<0.01)。两组患者治疗中不良反应发生情况比较，差异无统计学意义(P>0.05)。结论 低频重复经颅磁刺激作为一种无痛、无创、经济、安全的治疗方式对治疗原发性失眠症效果显著，同时不会增加不良反应的发生。
[关键词]失眠症；重复经颅磁刺激；无痛；安全
[中图分类号] R338.63 [文献标识码] A [文章编号] 1674-4721(2018)1(a)-0057-04
[Abstract]Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) for patients with primary insomnia.Methods 60 patients were diagnosed with "primary insomnia" who were treated in the psychiatric department of veterans hospital in Liaocheng city from November 2015 to November 2016 were selected as subjects.The random number table method was used to divide them into treatment group and control group，30 cases in each group.The patients in the treatment group were treated with rTMS，the patients in the control group were given fake stimulus for treamnet，which were treated 5 times a week，20 min each time，20 times in total.The PSQI scores before and after 2，4 weeks of treatment，the total efficiency of treatment and adverse reactions were compared between the two groups.Results Before treatment，the PSQI score was compared in both groups，and the difference was not statistically significant (P>0.05).After 2 and 4 weeks of treatment，the PSQI scores of both groups were lower than before treatment，the PSQI scores in the treatment group were significantly lower than those in the control group，the differences were statistically significant (P<0.01).The total treatment efficiency of patoients in the treatment group (96.7%) was higher than taht in the control group (26.7%)，the difference was statistically significant (P<0.01).The adverse reactions in the two groups were compared，and the difference was not statistically significant (P>0.05).Conclusion The rTMS which is painless，non-invasive，cost-effective and safe may help to improve insomnia without increase of the adverse events.
[Key words]Insomnia；Repetitive transcranial magnetic stimulation；Painless；Safe
睡眠是人类最基本的需求之一，占人类寿命总长的1/3，对于维持机体的健康必不可少，其质量的好坏与人体健康紧密相关，具有良好的睡眠是保证生活质量，完成各项社会活动的基本前提。在当今社会，竞争愈发激烈，因压力逐年增加，失眠症发病率也一路攀升，严重影响人们的健康、生活和工作。慢性失眠在世界范围内的发病率为26%，中国有10%～20%的成年人患有失眠症，在老年人群中则高达60%[1-5]。目前，失眠症的治疗主要以药物为主，药物治疗的效果较为迅速，但不能排除药物的不良反应，停药后易复发，长期服用易产生依懒性及耐受性，一旦停药还有可能出现戒断反应等，并且鉴于患者对药物治疗的抵触心理，服药不规律或拒服药，易致失眠症迁延不愈。因此提供更安全、有效的治疗失眠症的有效治疗方式迫在眉睫。重复经颅磁刺激(repetitive transcranial magnetic stimulation，rTMS)是一种非药物的治疗技术，操作简便、无痛无创、无依赖性、经济安全、新兴，因其可用于调节大脑皮层的兴奋性而被广泛用来治疗精神、神经疾病。目前国内探讨低频rTMS治疗失眠症疗效的报道较少。本研究选取2015年11月～2016年11月就诊于聊城市复退军人医院精神科门诊经诊断为“原发性失眠症”的60例患者作为研究对象，探讨低频重复经颅磁刺激治疗对原发性失眠症的效果，现报道如下。, 百拇医药(袁俊枚 李学欣 许耀坤)
[关键词]失眠症；重复经颅磁刺激；无痛；安全
[中图分类号] R338.63 [文献标识码] A [文章编号] 1674-4721(2018)1(a)-0057-04
[Abstract]Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) for patients with primary insomnia.Methods 60 patients were diagnosed with "primary insomnia" who were treated in the psychiatric department of veterans hospital in Liaocheng city from November 2015 to November 2016 were selected as subjects.The random number table method was used to divide them into treatment group and control group，30 cases in each group.The patients in the treatment group were treated with rTMS，the patients in the control group were given fake stimulus for treamnet，which were treated 5 times a week，20 min each time，20 times in total.The PSQI scores before and after 2，4 weeks of treatment，the total efficiency of treatment and adverse reactions were compared between the two groups.Results Before treatment，the PSQI score was compared in both groups，and the difference was not statistically significant (P>0.05).After 2 and 4 weeks of treatment，the PSQI scores of both groups were lower than before treatment，the PSQI scores in the treatment group were significantly lower than those in the control group，the differences were statistically significant (P<0.01).The total treatment efficiency of patoients in the treatment group (96.7%) was higher than taht in the control group (26.7%)，the difference was statistically significant (P<0.01).The adverse reactions in the two groups were compared，and the difference was not statistically significant (P>0.05).Conclusion The rTMS which is painless，non-invasive，cost-effective and safe may help to improve insomnia without increase of the adverse events.
[Key words]Insomnia；Repetitive transcranial magnetic stimulation；Painless；Safe
睡眠是人类最基本的需求之一，占人类寿命总长的1/3，对于维持机体的健康必不可少，其质量的好坏与人体健康紧密相关，具有良好的睡眠是保证生活质量，完成各项社会活动的基本前提。在当今社会，竞争愈发激烈，因压力逐年增加，失眠症发病率也一路攀升，严重影响人们的健康、生活和工作。慢性失眠在世界范围内的发病率为26%，中国有10%～20%的成年人患有失眠症，在老年人群中则高达60%[1-5]。目前，失眠症的治疗主要以药物为主，药物治疗的效果较为迅速，但不能排除药物的不良反应，停药后易复发，长期服用易产生依懒性及耐受性，一旦停药还有可能出现戒断反应等，并且鉴于患者对药物治疗的抵触心理，服药不规律或拒服药，易致失眠症迁延不愈。因此提供更安全、有效的治疗失眠症的有效治疗方式迫在眉睫。重复经颅磁刺激(repetitive transcranial magnetic stimulation，rTMS)是一种非药物的治疗技术，操作简便、无痛无创、无依赖性、经济安全、新兴，因其可用于调节大脑皮层的兴奋性而被广泛用来治疗精神、神经疾病。目前国内探讨低频rTMS治疗失眠症疗效的报道较少。本研究选取2015年11月～2016年11月就诊于聊城市复退军人医院精神科门诊经诊断为“原发性失眠症”的60例患者作为研究对象，探讨低频重复经颅磁刺激治疗对原发性失眠症的效果，现报道如下。, 百拇医药(袁俊枚 李学欣 许耀坤)