创伤后应激障碍物理治疗研究进展  

Progress in physical therapy for post-traumatic stress disorder

作　　者：刘斌 陈红怡 吴忠英 马竹静 宋磊 高幸 杨群 LIU Bin;CHEN Hongyi;WU Zhongying;MA Zhujing;SONG Lei;GAO Xing;YANG Qun(Department of Clinical Psychology,School of Military Medical Psychology,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学军事医学心理学系临床心理学教研室,西安710032

出　　处：《中国神经精神疾病杂志》2023年第9期570-576,共7页Chinese Journal of Nervous and Mental Diseases

基　　金：国家社会科学基金(编号:2022-SKJJ-B-057)。

摘　　要：创伤后应激障碍(post-traumatic stress disorder,PTSD)作为一种精神疾病,会严重损害患者的身心健康和社会功能。由于物理治疗可以直接作用于特定脑区并改善PTSD的核心症状,越来越多的物理治疗方法被应用于PTSD的治疗研究中。本文将PTSD物理治疗归纳为无创和有创物理治疗两大类。无创物理治疗方法包括电抽搐疗法、经颅直流电刺激、经颅磁刺激和Flexyx神经治疗技术,具有安全便捷、操作简单的优点,但刺激精准度有限;有创物理治疗方法包括深部脑刺激和星状神经节阻滞,其优点是刺激精准、不良反应少,但存在有手术风险、操作难度大和治疗花费高等局限性。此外,还有一些潜在物理治疗方法,包括经颅交流电刺激、磁抽搐疗法和迷走神经刺激,目前尚处于理论研究阶段。本文对以上物理治疗方法的作用机制、治疗参数、临床疗效、不良反应和最新技术形式进行总结与讨论,从而为PTSD的治疗提供参考。Post-traumatic stress disorder(PTSD),as a mental disorder disease,can seriously damage the physical and mental health and social functioning of patients.Physical therapy is increasingly being used in research on the treatment of PTSD due to its ability to directly target specific brain regions and improve the core symptoms of PTSD.This review categorizes on physical therapy for PTSD into two categories:non-invasive physical therapy and invasive physical therapy.Non-invasive physical therapy methods included electroconvulsive therapy,transcranial direct current stimulation,transcranial magnetic stimulation,and the Flexyx neurotherapy system.Non-invasive physical therapy had the advantages of safety,convenience,and simple operation.However,their stimulation accuracy was limited.Invasive physical therapy methods included deep brain stimulation and stellate ganglion block.Invasive physical therapy had the advantages of precise stimulation,fewer adverse reactions.However,there were surgical risks,high operational difficulty,and high treatment costs.In addition,potential physical therapy methods included transcranial alternating current stimulation,magnetic seizure therapy,and vagus nerve stimulation,which were currently in the theoretical research stage.This study discussed the mechanism of action,therapeutic parameters,clinical efficacy,adverse effects and the latest forms of technology of the above physical therapy methods,so as to provide reference for the treatment of PTSD.

关 键 词：创伤后应激障碍 物理治疗 电抽搐治疗 经颅直流电刺激 重复经颅磁刺激 深部脑刺激 星状神经节阻滞 临床疗效 不良反应 

分 类 号：R749.5[医药卫生—神经病学与精神病学]