重复经颅磁刺激治疗广泛性焦虑障碍的疗效及不良反应的meta分析  

Efficacy and adverse reactions of repetitive transcranial magnetic stimulation on general anxiety disorder：a meta-analysis

作　　者：李丽君[1] 胡卫疆[1] 高雅坤[1] 陈琦[1] 王春雪[1] 张宁[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经精神与临床心理科,国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所,脑血管病转化医学北京重点实验室,北京100050

出　　处：《中华行为医学与脑科学杂志》2016年第7期662-666,共5页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：背景重复经颅磁刺激（rTMS）已经逐步被应用于治疗广泛性焦虑障碍（GAD），作为一种新型的治疗手段，本文系统评价了rTMS治疗GAD患者的疗效及不良反应。方法计算机检索Pubmed、Cochrane library、OVID、CNKI、VIP数据库所有关于rTMS治疗GAD患者的随机对照试验（RCT），对符合纳入标准的文献使用ReVMan5．3软件对文献数据进行Meta分析。结果共纳入10个RCT研究进行recta分析，共计732人，根据研究内容（rTMS治疗结束后疗效随访观察和rTMS治疗疗效）的不同对患者进行亚组分析，结果显示：rTMS在治疗结束后的短期随访研究中显示疗效优于对照组（WMD=-5．02，95％CI=-6．84～-3．20，P〈0．01）；rTMSf预治疗能早期改善GAD患者的焦虑症状，低频、高频rTMS干预结果分别为WMD=-1．34，95％CI=～1．97～-0．71（P〈0．01）、WMD=-2．65，95％CI=-3．51～-1．79（P〈0．01）。干预组较对照组不良反应较少（WMD=-7．04，95％CI=-11．64～-2．43，P〈0．01）。结论rTMS干预治疗GAD患者治疗结束时及短期期随访疗效较好，rTMS干预治疗后起效快，干预组不良反应较少见。Objective Repetitive transcranial magnetic stimulation （rTMS） has gradually been used in the treatment of generalized anxiety disorder （GAD）.The efficacy and adverse reactions of repetitive transcranial magnetic stimulation on general anxiety disorder are assessed in the review.Methods Searched databases such as Pubmed, Cochrane library, OVID, CNKI, VIP by computer, and researched pubiished randomized controlled trials （RCTs） focused on repetitive transcranial magnetic stimulation on general anxiety disorder. Meta-analysis was conducted by RevMan 5.3 software. Results A total of 10 RCTs were included, involving 732 general anxiety disorder patients.The were divided into two subgroups, one group is eftect ob- servation,the other group is the improvement of curative effect in the treatment process. The effectiveness of intervention of rTMS follow up is better than that of the control group （WMD =- 5.02,95% CI=- 6.84- -3.20, P〈0.01 ） .The intervention of rTMS group can early ameliorate the symptom of anxiety.The results of low frequency and high frequency rTMS intervention is （ WMD = - 1. 34,95 % CI= - 1.97-- 0.71, P〈 0.01 ; WMD =-2.65,95% CI=-3.51--1.79, P〈0.01 ）.The adverse reactions of the intervention of rTMS group is less than that of the control group（WMD =-7.04,95% CI=-11.64--2.43, P〈0.01 ）. Conclusion rTMS intervention in the treatment of GAD patients at the end of the treatment and short-term follow-up efficacy is better, rTMS intervention after the onset of rapid intervention,the intervention group adverse reactions are rare.

关 键 词：广泛性焦虑障碍 重复经颅磁刺激 疗效 不良反应 META分析 

分 类 号：R749.72[医药卫生—神经病学与精神病学]