重复经颅磁刺激对酒依赖渴求状态的疗效观察  

The effects of repetitive transcranial magnetic stimulation on craving state of alcohol dependence patients

作　　者：孔祥娟[1] 苗庆山 翟爱玲[1] 翟金国[2] 陈敏[2] 张增[1] KONG Xiangjuan;MIAO Qingshan;ZHAI Ailing;ZHAI Jinguo;CHEN Min;ZHANG Zeng(Jining Psychiatric Hospital,Jining 272051,China;School of Mental Health,Jining Medical University,Jining 272013,China)

机构地区：[1]济宁市精神病防治院,济宁272051 [2]济宁医学院精神卫生学院,济宁272013

出　　处：《济宁医学院学报》2020年第5期330-334,共5页Journal of Jining Medical University

基　　金：济宁市科技发展计划项目(67)。

摘　　要：目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对降低酒依赖患者渴求的影响。方法选取2017年10月至2018年12月在济宁市精神病防治院住院的酒依赖患者100例为研究对象,随机分为观察组和对照组,每组50例,进行2周的酒精戒断治疗后分别给予4周的rTMS和伪刺激治疗。应用宾夕法尼亚酒精渴求量表(PACS)、密西根酒精依赖调查问卷(MAST)评估两组患者入组时、治疗后1个月、6个月、12个月对酒精的渴求及酒依赖的严重程度,同时应用症状自评量表(SCL-90)和社会功能缺陷筛选量表(SDSS)评估其精神状况及社会功能。患者在12月内复饮标记为复饮病例不再评估。结果两组患者的年龄、教育年限、婚姻、职业、家族史、初次饮酒年龄、饮酒时间、嗜酒时间、每日酒精摄入量均无显著性差异(P>0.05)。治疗后1个月,观察组复饮率4%,对照组复饮率18%,差异具有统计学意义(P<0.05);两组间PACS、MAST、SCL-90得分有显著性差异(P<0.05),SDSS无显著性差异(P>0.05)。6个月后观察组复饮率34%,对照组复饮率44%,差异具有统计学意义(P<0.05);两组间未复饮患者的PACS、MAST得分有显著性差异(P<0.05),但SCL-90及SDSS得分无显著性差异(P>0.05)。12个月后观察组复饮率64%,对照组复饮率72%,差异具有统计学意义(P<0.05);两组未复饮患者的PACS、MAST、SCL-90、SDSS均无显著性差异(P>0.05)。结论rTMS能够有效帮助酒依赖患者降低对酒精的渴求,同时改善其精神症状和社会功能;rTMS的效果治疗早期明显,随着时间的延长治疗效果逐渐减弱。Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on reducing craving in alcohol dependence patients.Methods 100 patients with alcohol dependence in Jining psychiatric hospital from October 2017 to December 2018 were randomly divided into observation group and control group,each group with 50 cases.After 2 weeks of alcohol withdrawal treatment,the control group was treated with rTMS and the observation group was treated with pseudo stimulation for 4 weeks respectively.Pennsylvanian alcohol craving scale(PACS)and Michigan Alcohol Dependence Questionnaire(MAST)were used to evaluate the alcohol craving and alcohol dependence severity at the time of admission,1 month,6 months and 12 months after treatment,and their mental status and social function were assessed by symptom checklist 90(SCL-90)and social function deficiency screening scale(SDSS).Patients who relapsed within 12 months were marked as relapse cases and stop evaluating.Results There were no significant differences in age,education years,marriage,occupation,family history,first drinking age,drinking time and daily alcohol intake between the two groups.One month after treatment,the re-drinking rate of the observation group was 4%and that of the control group was 18%,the difference was statistically significant(P<0.05);there were significant differences in the scores of PACS、MAST and SCL-90 between the two groups(P<0.05),but there was no significant difference in SDSS(P>0.05).After 6 months,the re-drinking rate of the observation group was 34%,and that of the control group was 44%,the difference was statistically significant(P<0.05);there were significant differences in PACS and MAST scores between the two groups(P<0.05),but there was no significant difference in the scores of SCL-90 and SDSS(P>0.05).After 12 months,the rehydration rate of the observation group was 64%,and that of the control group was 72%,the difference was statistically significant(P<0.05);the PACS、MAST、SCL-90 and SDSS of the two groups had no s

关 键 词：酒依赖 重复经颅磁刺激 渴求 复饮 

分 类 号：R749.62[医药卫生—神经病学与精神病学]