重复经颅磁刺激结合正念减压疗法、针刺对广泛性焦虑障碍患者负性情绪及认知功能的影响  

Effect of repetitive transcranial magnetic stimulation combined with mindfulness decompression therapy and acupuncture on negative emotion and cognitive function in patients with generalized anxiety disorder

作　　者：杨洪敬 武业琛 巨星[1] 于兴晨 庞堃[1] 张铮 杨桂君[1] 李佳音 贾铎 YANG Hongjing;WU Yechen;JU Xing;YU Xingchen;PANG Kun;ZHANG Zheng;YANG Guijun;LI Jiayin;JIA Duo(Department of Rehabilitation,Qinhuangdao Jiulongshan Hospital,Qinhuangdao,Hebei 066000;Artificial Intelligence Major,School of Electronics and Information Engineering,Harbin Institute of Technology,Shenzhen,Shenzhen,Guangdong 518055)

机构地区：[1]河北省秦皇岛市九龙山医院康复科,河北秦皇岛066000 [2]哈尔滨工业大学(深圳)电子与信息工程学院,广东深圳518055

出　　处：《河北中医》2024年第12期1981-1985,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：秦皇岛市科学技术研究与发展计划(编号:202301A151)。

摘　　要：目的重复经颅磁刺激结合正念减压疗法、针刺对广泛性焦虑障碍患者负性情绪及认知功能的影响。方法将80例广泛性焦虑障碍患者按照随机数字表法分为2组。对照组38例予正念减压疗法联合针刺治疗,治疗组42例在对照组治疗基础上加重复经颅磁刺激治疗,2组均治疗6周后评价疗效,比较2组治疗组前及治疗1、2、6周丙二醛(MDA)、超氧化物歧化酶(SOD)水平及中医症状评分、匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表-17(HAMD-17)、汉密尔顿焦虑量表(HAMA)、蒙特利尔认知评估量表(MoCA)评分。结果治疗1、2、6周,2组烦躁易怒、口苦口干、PSQI、HAMD-17、HAMA评分均较本组治疗前降低(P<0.05),且治疗组均低于对照组同期(P<0.05)。治疗1、2、6周,2组MoCA评分均较本组治疗前升高(P<0.05),且治疗组均高于对照组同期(P<0.05)。治疗1、2、6周,2组MDA水平均较本组治疗前降低(P<0.05),SOD水平均较本组治疗前升高(P<0.05);治疗1、2、6周,治疗组MDA水平均低于对照组同期(P<0.05),SOD水平均高于对照组同期(P<0.05)。治疗组总有效率92.86%(39/42),对照组总有效率71.05%(27/38),治疗组总有效率高于对照组(P<0.05)。结论重复经颅磁刺激结合正念减压疗法、针刺治疗广泛性焦虑障碍,能改善患者负性情绪及认知功能,抑制机体氧化应激反应,提高睡眠质量。Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)combined with mindfulness decompression therapy and acupuncture on negative emotion and cognitive function in patients with generalized anxiety disorder(GAD).Methods Eighty GAD patients were randomly assigned into treatment group(n=42)and control group(n=38).All patients were managed by mindfulness decompression therapy combined with acupuncture,and those in treatment group were additionally treated with rTMS.Treated for 6 weeks,the aim was to compare malondialdehyde(MDA),superoxide dismutase(SOD),traditional Chinese medicine(TCM)symptom score,Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Rating Scale-17(HAMD-17),Hamilton Anxiety Scale(HAMA),Montreal Cognitive Assessment(MoCA)scores on day 0,and at weeks 1,2 and 6 of treatment.The curative effect was assessed.Results At weeks 1,2 and 6 of treatment,TCM symptom(dysphoria and irritable,bitter taste and mouth dryness)scores,PSQI,HAMD-17,HAMA scores in groups were significantly decreased(P<0.05),which were significantly lower in the treatment group than in the control group(P<0.05).MoCA scores in groups at weeks 1,2 and 6 were significantly increased(P<0.05),which were significantly increased in the treatment group relevant to the control group(P<0.05).At weeks 1,2 and 6 of treatment,significantly decreased MDA level and increased SOD level were found in groups(all P<0.05),and the treatment group was superior to the control group for MDA and SOD levels(all P<0.05).The overall effective rate in the treatment group was significantly higher than that in the control group(92.86%[39/42]vs 71.05%[27/38],P<0.05).Conclusion The rTMS combined with mindfulness decompression therapy and acupuncture can improve negative emotion and cognitive function,inhibit the body's oxidative stress response,and improve sleep quality in GAD patients.

关 键 词：经颅磁刺激 广泛性焦虑障碍 正念 负性情绪 认知功能障碍 

分 类 号：R749.059[医药卫生—神经病学与精神病学]