经颅磁、电刺激治疗酒精使用障碍伴亚谵妄综合征的临床研究  

Clinical study on transcranial magnitic stimulation and transcranial direct current stimulation in the treatment of alcohol use disorders with subsyndromal delirium

作　　者：张力国 卜春莹 聂峰 潘鑫 朱玺华 ZHANG Liguo;BU Chunying;NIE Feng;PAN Xin;ZHU Xihua(Department of Psychiatry,the Third Hospital of Heilongjiang Province,Bei'an 164000,China)

机构地区：[1]黑龙江省第三医院精神科,黑龙江北安164000

出　　处：《长春中医药大学学报》2024年第5期571-575,共5页Journal of Changchun University of Chinese Medicine

基　　金：黑龙江省卫生健康委科研课题(20210485)。

摘　　要：目的评估经颅磁刺激(rTMS)、经颅电刺激(tDCS)加载常规治疗的综合干预方案相比常规治疗对酒精使用障碍(alcohol use disorder,AUD)伴亚谵妄综合征(subsyndromal delirium,SSD)的效果。方法纳入46例男性酒精使用障碍伴亚谵妄综合征患者,按照1:1的比例随机分为联合治疗组与常规治疗组。常规治疗组予口服地西泮以及补充维生素、保肝、护脑、补液和纠正电解质紊乱等治疗;联合治疗组在此基础上予重复经颅磁刺激与经颅电刺激治疗。治疗2周后,评价谵妄评定方法(Confusion Assessment Method,CAM)评分、DRSR-98量表评分;随访3个月后,评估酒精摄入量。结果联合治疗组有效率95.65%,常规治疗组有效率86.96%,组间对比差异无统计学意义(P>0.05);与治疗前比较,2组DRSR-98量表评分差异均有统计学意义(P<0.05),且2组月酒精摄入量与过度饮酒天数均明显降低(P<0.05);随访3个月,联合治疗组月酒精摄入量与过度饮酒天数明显低于常规治疗组(P<0.001)。结论相比常规治疗,尽管联合治疗在短期内未能更进一步促进SSD的恢复,但随访过程中显示联合治疗组具有明显下降的酒精摄入量,远期疗效方面可能具有更好的获益。Objective To evaluate the respective therapeutic effects of comprehensive intervention scheme consisting of repeated transcranial magnetic stimulation(rTMS)and transcranial direct current stimulation(tDCS)combined with conventional treatment,and conventional treatment for alcohol use disorder(AUD)with subsyndromal delirium(SSD).Methods 46 male patients with AUD accompanied by SSD were randomly divided into the combination treatment group and the conventional treatment group in a 1:1 ratio.The conventional treatment group was treated with oral administration of diazepam,as well as vitamin supplementation,liver protection,brain protection,fluid infusion,and correction of electrolyte imbalances.The combination treatment group received rTMS and tDCS on the basis of the treatment of the conventional treatment group.Confusion Assessment Method(CAM)score and DRSR-98 scale were evaluated after 2 weeks of treatment;And alcohol intake was assessed after 3 months of followup.Results The effective rate of the combination treatment group was 95.65%,while that of the conventional treatment group was 86.96%.There was no statistically significant difference between the groups(P>0.05).Conpared with before treatment,there was statistically significant difference in DRSR-98 scores between two groups(P<0.05),and the monthly alcohol intake and excessive drinking days in both groups were significantly reduced(P<0.05).After 3-month follow-up,the monthly alcohol intake and excessive drinking days in the combination treatment group were significantly lower than those in the conventional treatment group(P<0.001).Conclusion Compared with the conventional treatment,although the combination treatment can not further promote the recovery of SSD in the short term,follow-up shows that the combination treatment group has significant decrease in alcohol intake,and may have better long-term efficacy benefits.

关 键 词：酒精使用障碍 亚谵妄综合征 经颅电刺激 经颅磁刺激 

分 类 号：R749[医药卫生—神经病学与精神病学]