重复经颅磁刺激治疗脑卒中后失眠效果及对患者焦虑抑郁状态的影响  

Effect of repetitive transcranial magnetic stimulation on post-stroke insomnia,anxiety,and depression

作　　者：齐文耀 齐钢桥 梁胤 曹敏敏[1] QI Wenyao;QI Gangqiao;LIANG Yin;CAO Minmin(Sleep Center,Taizhou Second People′s Hospital in Zhejiang Province,Taizhou 317200,China)

机构地区：[1]浙江省台州市第二人民医院睡眠中心,浙江台州317200

出　　处：《中国现代医生》2022年第12期100-103,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY899)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)治疗脑卒中后失眠的临床效果及对患者焦虑抑郁状态的影响。方法选择台州市第二人民医院2018年12月至2020年12月收治的脑卒中后失眠患者91例,采用随机数字表法分为常规组(45例,阿普唑仑片)与观察组(46例,rTMS治疗)。治疗前后采用匹兹堡睡眠质量指数(PSQI)评价患者睡眠情况,采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损情况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价焦虑抑郁情况,比较两组治疗期间不良反应发生情况。结果治疗后观察组的PSQI评分(6.73±1.23)分、NIHSS评分(7.51±1.74)分、SAS评分(34.60±4.66)分、SDS评分(35.71±4.16)分分别低于常规组的(10.32±2.96)分、(17.42±3.11)分、(45.74±6.82)分、(46.23±6.67)分,差异有统计学意义(P<0.001);观察组的不良反应发生率为6.52%(3/46),低于常规组的24.44%(11/45),差异有统计学意义(P<0.05)。结论rTMS治疗脑卒中后失眠疗效肯定,有助于改善患者的睡眠情况与神经功能缺损程度,减轻焦虑抑郁情况,安全性高。Objective To explore the clinical effect of repetitive transcranial magnetic stimulation(rTMS)on post-stroke insomnia and its influence on anxiety and depression.Methods Ninety-one patients with post-stroke insomnia admitted to Taizhou Second People′s Hospital from December 2018 to December 2020 were selected and randomly divided into the conventional group(45 cases,alprazolam tablets)and the observation group(46 cases,rTMS treatment).Before and after treatment,the Pittsburgh sleep quality index(PSQI)was used to evaluate patients′sleep.The national institute of health stroke scale(NIHSS)was used to evaluate neurological deficits.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the anxiety and depression.The incidence of adverse reactions during treatment was compared between the two groups.Results After treatment,PSQI score(6.73±1.23)points,NIHSS score(7.51±1.74)points,SAS score(34.60±4.66)points,and SDS score(35.71±4.16)points in the observation group were lower than those in the conventional group(10.32±2.96)points,(17.42±3.11)points,(45.74±6.82)points and(46.23±6.67)points,and the differences had statistical significance(P<0.001).The incidence rate of adverse reactions in the observation group was 6.52%(3/46),which was lower than 24.44%(11/45)in the conventional group,and the differences had statistical significance(P<0.05).Conclusion rTMS is effective in the treatment of post-stroke insomnia,which helps to improve the sleep status and the degree of neurological deficits of patients and reduce anxiety and depression,with high safety.

关 键 词：重复经颅磁刺激 脑卒中 失眠 神经功能 焦虑 抑郁 安全性 

分 类 号：R743[医药卫生—神经病学与精神病学]