重复经颅磁刺激治疗脑卒中后抑郁睡眠障碍的疗效分析  

Analysis of therapeutic effect of repeated transcranial magnetic stimulation on post-stroke depression and sleep disturbance

作　　者：王韵喃[1] 杨轩[1] 文翠[1] 卢华安[1] 林敏婷[1] 陈韵聪[1] Wang Yunren;Yang Xuan;Wen Cui;Lu Hua＇an;Lin Minting;Chen Yuncong(Foshan City,Guangdong Province,China Chancheng District on the 6th Road,Foshan City Hospital,52800)

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《广州医科大学学报》2017年第4期30-33,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨重复经颅磁刺激对脑卒中后抑郁睡眠障碍效果的影响。方法:我院2015年1月至2016年6月收治的脑卒中后抑郁患者120例,随机平均分为两组,对照组60例,给予缺血性脑卒中基础治疗+氟西汀片。观察组60例,给予在缺血性脑卒中基础治疗上加用r TMS连续刺激30 min/次,1次/天,共7天的治疗;两组患者的疗程均为3个月。分别与治疗前后采用抑郁程度的汉密尔顿抑郁量表(HAMD)、、抑郁自评量表(SDS)评分评定其抑郁症状改善情况;多导睡眠仪(polysomography,PSG)通过同步记录30例住院患者睡眠时的生理指标。结果:治疗后,两组SDS、HAMD评分均降低,与治疗前比较差异具有统计学意义(P<0.05),且观察组较对照组明显下降(P<0.05);睡眠障碍指标A H I(n/h)、最低Sa O2(%)、最长呼吸暂停时间(秒)、NREM(Ⅲ、Ⅳ)占总睡眠时间(%)、REM占总睡眠时间(%)观察组均优于对照组(P<0.05)。结论:对脑卒中后抑郁患者实施重复经颅磁刺激,可更好地提高患者改善患者的抑郁状态,促进患者的睡眠,对患者抑郁状况及睡眠的改善具有重要的临床意义。Objective：To investigate the effect of repeated transcranial magnetic stimulation on post-stroke depression and sleep disturbance.Methods：One hundred and twenty patients with poststroke depression from January 2015 to June 2016 were randomly divided into two groups,the control group（60 cases）,the basic treatment of ischemic stroke ＋ fluoxetine tablets.60 patients in the observation group were treated with r TMS for30 minutes every time for 7 days in the basic treatment of ischemic stroke.The course of treatment in both groups was 3 months.（HAMD） and depression self-rating scale（SDS） scores were used to evaluate the depressive symptoms of patients before and after treatment.Polysomography（PSG） was used to record 30 patients with sleep When the physiological indicators.Results：After treatment,the scores of SDS and HAMD in the two groups were significantly lower than those in the control group（P〈0.05）,and the difference was statistically significant（P〈0.05）（P〈0.05）,the lowest sleep apnea time（seconds）,NREM（Ⅲ Ⅳ）,the total sleep time（%） and the total sleep time（REM） in the observation group were better than those in the control group（P〈0.05）.Conclusion：Repeated transcranial magnetic stimulation in patients with post-stroke depression can improve the patients＇ depression and improve their sleep.It has important clinical significance in improving the patients＇ depression and sleep.

关 键 词：脑卒中后抑郁 重复经颅磁刺激 睡眠障碍 抑郁状况 

分 类 号：R473.74[医药卫生—护理学]