重复经颅磁刺激治疗慢性失眠的疗效及认知功能、睡眠改善效果  

The Efficacy of Repeated Transcranial Magnetic Stimulation in the Treatment of Chronic Insomnia and the Improvement of Cognitive Function and Bad Mood

作　　者：陆艺[1] 王玮[1] 米国琳[2] 简佳[3] 郑云哨[4] 刘金同[5] LU Yi;WANG Wei;MI Guo-lin;JIAN Jia;ZHENG Yun-shao;LIU Jin-tong(Department of Physical Therapy,Shandong Mental Health Center,Jinan Shandong 250014,China;Department of Psychosomatic Medicine,Shandong Mental Health Center,Jinan Shandong 250014,China;Department of Psychiatry I,Shandong Mental Health Center,Jinan Shandong 250014,China;Department of Psychiatry V,Shandong Mental Health Center,Jinan Shandong 250014,China;Department of Psychological Behavior of Children and Adolescents I,Shandong Mental Health Center,Jinan Shandong 250014,China)

机构地区：[1]山东省精神卫生中心物理治疗科,山东济南250014 [2]山东省精神卫生中心心身医学科,山东济南250014 [3]山东省精神卫生中心精神一科,山东济南250014 [4]山东省精神卫生中心精神五科,山东济南250014 [5]山东省精神卫生中心儿童青少年心理行为一科,山东济南250014

出　　处：《中华养生保健》2023年第1期1-4,共4页CHINESE HEALTH CARE

基　　金：山东省精神卫生中心科技发展计划项目(2019YJ02)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)治疗慢性失眠的疗效及认知功能、睡眠质量、睡眠信念和态度改善效果。方法选择2019年1月~2019年12月山东省精神卫生中心收治的240例慢性失眠患者为研究对象,按随机数表法将其分为左侧背外侧前额叶皮层(DLPFC)治疗组、右侧DLPFC治疗组、中央点(Cz)后1 cm治疗组、对照组(假刺激组),每组60例。分别在治疗前、治疗结束时使用匹兹堡睡眠质量指数(PSQI)、睡眠个人信念和态度量表(DBAS)对患者睡眠质量、睡眠信念和态度进行评价;使用蒙特利尔认知评估量表(MoCA)、符号数字转换测验(SDMT)和事件相关电位(ERPs)分别在神经心理和电生理方面对患者的认知功能进行评估。结果治疗后,左侧DLPFC治疗组、右侧DLPFC治疗组、Cz后1 cm治疗组PSQI评分低于治疗前,DBAS评分高于治疗前,差异具有统计学意义(P<0.05);对照组PSQI、DBAS治疗前后比较,差异无统计学意义(P>0.05);治疗后,右侧DLPFC治疗组PSQI、DBAS评分低于左侧DLPFC治疗组、Cz后1 cm治疗组,差异均具有统计学意义(P<0.05);左侧DLPFC治疗组、右侧DLPFC治疗组、Cz后1 cm治疗组MoCA、SDMT评分高于治疗前,差异均具有统计学意义(P<0.05);对照组MoCA、SDMT治疗前后比较,差异无统计学意义(P>0.05);左侧DLPFC治疗组、右侧DLPFC治疗组、Cz后1 cm治疗组治疗后P3潜伏期短于治疗前,P3波幅显著大于治疗前,差异均具有统计学意义(P<0.05);对照组P3潜伏期、P3波幅治疗前后比较,差异无统计学意义(P>0.05)。结论rTMS可显著改善患者的认知功能、睡眠质量、睡眠信念和态度,效果显著,值得在临床应用。Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in the treatment of chronic insomnia and the improvement of cognitive function,sleep quality,sleep belief and attitude.Methods A total of 240 patients with chronic insomnia who met the inclusion criteria and were treated in the Shandong Mental Health Center from January to December 2019 were selected as the research objects.They were randomly divided into left dorsolateral prefrontal cortex(DLPFC)treatment group,right DLPFC treatment group,1 cm behind the central point(Cz)treatment group and control group(sham stimulation group),with 60 cases in each group.Pittsburgh sleep quality index(PSQI)and sleep personal belief and attitude scale(DBAS)were used to evaluate the patients’sleep quality,sleep belief and attitude before and at the end of treatment.The cognitive function of patients was evaluated in neuropsychological and electrophysiological aspects by Montreal Cognitive Assessment Scale(MoCA),symbol number conversion test(SDMT)and event-related potentials(ERPs).Results The PSQI scores of left DLPFC treatment group,right DLPFC treatment group and 1 cm after Cz treatment group were signifi cantly lower than those before treatment,and the DBAS scores were signifi cantly higher than those before treatment(P<0.05).There was no signifi cant diff erence between PSQI and DBAS before and after treatment in the control group(P>0.05).The PSQI and DBAS of right DLPFC treatment group were signifi cantly lower than those of left DLPFC treatment group and 1 cm after CZ treatment group;MoCA and SDMT in the left DLPFC treatment group,the right DLPFC treatment group and the treatment group 1 cm after CZ were signifi cantly higher than those before treatment(P<0.05),but there was no signifi cant diff erence in MoCA and SDMT before and after treatment in the control group(P>0.05);The P3 latency after treatment was signifi cantly shorter in the left DLPFC treatment group,the right DLPFC treatment group and the treatment group 1 cm after CZ,

关 键 词：重复经颅磁刺激 慢性失眠 认知功能 不良情绪 疗效 

分 类 号：R740[医药卫生—神经病学与精神病学]