目的 探讨采用重复经颅磁刺激(repeated transcranial magnetic stimulation,rTMS)和针刺疗法治疗慢性失眠障碍(chronic insomnia disorder,CID)患者的临床效果.方法 选取2022年1月至2023年12月于南昌市第一医院就诊的CID患者80例,根据随机数字表法分为对照组和治疗组,每组40例.对照组患者使用右佐匹克隆治疗,治疗组患者在对照组的基础上增加rTMS和针刺疗法,疗程4周,观察治疗前后两组患者的睡眠质量、睡眠相关指标及心理状况改善程度.结果 治疗后两组患者的匹兹堡睡眠质量指数评分均下降(P＜0.05);睡眠潜伏期、觉醒次数均低于治疗前(P＜0.05),总睡眠时间、睡眠效率、快速眼动睡眠期睡眠占比均高于治疗前,且治疗组比对照组改善更明显(P＜0.05).治疗后两组患者的汉密尔顿焦虑、抑郁量表评分与治疗前比较均降低,但对照组治疗前后比较,差异无统计学意义(P＞0.05),治疗组治疗前后比较,差异有统计学意义(P＜0.05).结论 rTMS联合针刺治疗CID患者可明显改善其睡眠质量,同时还可减轻伴随的焦虑和抑郁症状.
Clinical efficacy of repeated transcranial magnetic stimulation combined with acupuncture for chronic insomnia
Objective To explore the clinical efficacy of repeated transcranial magnetic stimulation(rTMS)and acupuncture therapy in the treatment of chronic insomnia disorder(CID)patients.Methods A total of 80 patients with CID,who were treated at Nanchang First Hospital from January 2022 to December 2023,were selected for the study.The patients were randomly divided into control group and treatment group,with 40 cases in each group.The control group patients were treated with dexmedetomidine,while the treatment group patients received rTMS and acupuncture therapy in addition to control group.The treatment course was 4 weeks,and the sleep quality,sleep related indicators,and psychological condition improvement of both groups of patients were observed before and after treatment.Results After treatment,the Pittsburgh sleep quality index scores of both groups of patients decreased(P＜0.05);The sleep latency and number of awakenings were lower than before treatment(P＜0.05),and the total sleep time,sleep efficiency,and proportion of rapid eye movement sleep were higher than before treatment,treatment group showed more significant improvement than control group(P＜0.05).After treatment,the Hamilton anxiety and depression scale scores of both groups of patients decreased compared to before treatment,but there was no statistically significant difference in control group before and after treatment(P＞0.05).However,there was a statistically significant difference in treatment group before and after treatment(P＜0.05).Conclusion The combination of rTMS and acupuncture treatment can significantly improve the sleep quality of CID patients,while also reducing the accompanying symptoms of anxiety and depression.
Chronic insomnia disorderRepeated transcranial magnetic stimulationAcupunctureDexzopicloneCombination therapy
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