光照治疗在双相障碍抑郁发作患者中应用研究进展  

Research progress on the application of light therapy in patients with bipolar depression

作　　者：刘滔[1] 戴旭 黄贺滨 陈宁宁 田鑫荷 郑文静 卢玮聪 徐贵云[1] 苏国辉[2] 林康广[1] LIU Tao;DAI Xu;HUANG Hebin;CHEN Ningning;TIAN Xinhe;ZHENG Wenjing;LU Weicong;XU Guiyun;SO Kwok-fai;LIN Kangguang(Department of Affective Disorders,The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,China)

机构地区：[1]广州医科大学附属脑科医院情感科,广州510370 [2]暨南大学粤港澳中枢神经再生研究所

出　　处：《中国神经精神疾病杂志》2024年第4期252-256,I0001,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：广州市科技计划项目(编号:2023A03J0437);广东省基础与应用基础研究基金项目(编号:2023A1515011484)。

摘　　要：现有抗抑郁治疗方法对双相障碍(bipolar disorder,BD)抑郁发作期患者的疗效不甚理想。多项研究探索了光照治疗BD抑郁发作期患者的疗效,并对光疗的参数、设备和安全性等进行研究。较多meta分析和随机对照研究表明光疗能明显改善BD患者的抑郁症状,无论是低光强还是高光强的白光均有这种效果,蓝光抗抑郁疗效尚不明确。光疗起效快,最好在清晨进行,每次持续30~60 min不等,对患者最有益的光照疗程尚无定论。目前最常用的光疗设备是灯箱,光疗眼镜的安全性有待探索。如选择符合安全标准的光疗灯,BD患者光疗整体安全性较高,转躁狂或轻躁狂风险低。总之,光照治疗BD抑郁发作期患者具有较好前景,未来可开展更多的BD患者光疗研究,以期形成BD患者的光疗处方。Existing antidepressant treatments are generally suboptimal for patients with bipolar disorder(BD).Several studies have explored the efficacy of light therapy(LT)in patients with bipolar depression,along with investigating parameters,devices,and safety aspects of LT.This paper provides a review of these aspects.Numerous meta-analyses and randomized controlled trials have indicated that LT could significantly improve depressive symptoms in BD patients,with both low and high intensity white light having this effect,while the antidepressant effect of blue light remains unclear.LT takes effect rapidly,preferably in the morning,with each session lasting between 30 to 60 minutes,but there is no consensus on the most beneficial LT course for BD patients.The most commonly used device for LT is a lightbox.However further exploration is need regarding the safety of LT glasses.When LT devices that meet safety standards is selected,the overall safety of LT will be high and risk of manic or hypomanic switch will be low for BD patients.In conclusion,LT holds promise for patients with bipolar depression,and further research on LT for BD patients should be conducted to explore LT strategies and develop LT prescriptions.

关 键 词：光照治疗 双相障碍 抑郁症状 疗效 参数 光疗设备 安全性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]