摘要
目的:探讨高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)改善酒精依赖患者睡眠与抑郁障碍的效果.方法:选取 2022 年 8 月—2023 年 2 月赣州市第三人民医院收治的酒精依赖患者 80 例为研究对象,按照随机数字表法分为两组,每组 40 例.对照组进行伪刺激治疗,观察组采用高频rTMS治疗,两组均维持治疗 4 周.对比两组治疗前、治疗 4 周后的失眠严重程度指数(insomnia severity index,ISI)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)评分及神经递质水平.结果:治疗前,两组ISI、PSQI各项评分及总分、SDS评分、SAS评分、多巴胺(dopamine,DA)水平、5-羟色胺(5-hydroxytryptamine,5-HT)水平比较,差异均无统计学意义(P＞0.05);治疗 4 周后,观察组的日间功能障碍[(1.01±0.11)分]、睡眠障碍[(0.84±0.39)分]、入睡时间[(0.96±0.17)分]、睡眠效率[(1.01±0.15)分]、睡眠时间[(0.71±0.28)分]、睡眠质量[(0.87±0.24)分]、催眠药物[(0.73±0.22)分]及总分[(6.13±0.51)分]、ISI[(5.17±2.12)分]、SDS[(39.27±7.15)分]、SAS[(32.15±6.33)分]、DA[(71.32±4.35)ng/L]均低于对照组[(1.53±0.21)分、(1.34±0.60)分、(1.65±0.36)分、(1.44±0.32)分、(1.30±0.35)分、(1.53±0.31)分、(1.30±0.34)分、(10.09±0.82)分、(8.36±4.09)分、(47.22±8.56)分、(43.05±7.96)分、(87.88±5.62)ng/L],观 察 组 的 5-HT[(269.72±27.04)ng/mL]高于对照组[(197.33±25.88)ng/mL],差异均有统计学意义(P＜0.05).结论:高频rTMS治疗能够明显改善酒精依赖患者的睡眠质量,有效缓解患者负面情绪,进一步提升患者神经功能.
Abstract
Objective:To investigate the effects of high-frequency repetitive transcranial magnetic stimulation(rTMS)on improving sleep and depressive disorder in patients with alcohol dependence.Method:A total of 80 patients with alcohol dependence admitted to the Third People's Hospital of Ganzhou from August 2022 to February 2023 were selected as the study objects,and were divided into two groups according to random number table method,with 40 patients in each group.The control group received pseudo-stimulation therapy,and the observation group received high-frequency rTMS therapy.Both groups were maintained for 4 weeks.Insomnia severity index(ISI),Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS),self-rating anxiety scale(SAS)scores and neurotransmitter levels were compared between the two groups before treatment and 4 weeks after treatment.Result:Before treatment,there were no significant differences in ISI,each item scores and total scores of PSQI,SDS scores,SAS scores,dopamine(DA)level,5-hydroxytryptamine(5-HT)level between the two groups(P＞0.05).4 weeks after treatment,daytime dysfunction[(1.01±0.11)scores],sleep disorder[(0.84±0.39)scores],initiating sleep time[(0.96±0.17)scores],sleep efficiency[(1.01±0.15)scores],sleep time[(0.71±0.28)scores],sleep quality[(0.87±0.24)scores],hypnotic drug[(0.73±0.22)scores]and total score[(6.13±0.51)scores],ISI[(5.17±2.12)scores],SDS[(39.27±7.15)scores],SAS[(32.15±6.33)scores],DA[(71.32±4.35)ng/L]in the observation group were lower than those in the control group[(1.53±0.21)scores,(1.34±0.60)scores,(1.65±0.36)scores,(1.44±0.32)scores,(1.30±0.35)scores,(1.53±0.31)scores,1.30±0.34)scores,(10.09±0.82)scores,(8.36±4.09)scores,(47.22±8.56)scores,(43.05±7.96)scores,(87.88±5.62)ng/L],and the 5-HT[(269.72±27.04)ng/mL]in observation group was higher than that in control group[(197.33±25.88)ng/mL],the differences were statistically significant(P＜0.05).Conclusion:High-frequency rTMS therapy can significantly improve the sleep quality of patients with alcohol dependence,effectively relieve patients'negative emotion,and further enhance patients'neurological function.
维普
万方数据