脑电生物反馈治疗对抑郁症患者睡眠质量及自主神经功能的影响  

Effects of EEG biofeedback treatment on sleep quality and autonomic nervous function in patients with depression

作　　者：邓江南 叶鑫武 赵飞飞 DENG Jiangnan;YE Xinwu;ZHAO Feifei(Department of General Psychiatry,Wenzhou Municipal Seventh People’s Hospital,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市第七人民医院普通精神科,浙江温州325000

出　　处：《重庆医学》2025年第1期127-131,137,共6页Chongqing Medical Journal

基　　金：浙江省温州市科研项目(Y20211137)。

摘　　要：目的探讨脑电生物反馈对抑郁症睡眠障碍患者睡眠质量及自主神经功能的影响。方法选取2020年1月至2021年8月该院住院治疗的98例抑郁症睡眠障碍患者为研究对象。根据随机数字表法分为研究组和对照组,每组49例。对照组采用艾司西酞普兰治疗,研究组在此基础上联合脑电生物反馈治疗。比较治疗前、治疗3个月后两组汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)评分、主观失眠症状评分、心率变异性(HRV)指标、血清神经肽Y(NPY)、5-羟色胺(5-HT)水平及不良反应发生率。结果研究组总有效率高于对照组(95.92%vs.81.63%),差异有统计学意义(P<0.05)。治疗3个月后两组HAMD、PSQI、主观失眠症状评分及相邻R-R间期差值>50 ms个数所占全部的百分比(PNN50)较治疗前降低,且研究组低于对照组;而全部正常窦性心率R-R间期标准差(SDNN)、每5分钟正常RR间期平均值标准差(SDANN)、低频功率(LF)、高频功率(HF)、血清NPY、5-HT水平较治疗前升高,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组与对照组不良反应发生率比较(14.29%vs.10.20%),差异无统计学意义(P>0.05)。结论脑电生物反馈联合艾司西酞普兰可明显改善抑郁症患者抑郁症状及睡眠质量,调节自主神经功能,提高血清NPY、5-HT水平。Objective To explore the effects of EEG biofeedback on the sleep quality and autonomic nervous function in the patients with depression sleep disorder.Methods A total of 98 inpatients with depressive sleep disorder treated in this hospital from January 2020 to August 2021were selected as the study subjects and divided into the study group and control group according to the random number table method,49 cases in each group.The control group adopted the escitalopram treatment,and the study group was combined with EEG biofeedback on this basis.The Hamilton Depression Scale(HAMD)score,Pittsburgh Sleep Quality Index(PSQI)score,subjective insomnia symptom score,heart rate variability(HRV)index,serum neuropeptide Y(NPY)and 5-hydroxytryptamine(5-HT)levels and the incidence rate of adverse reactions before treatment and in 3 months of treatment were compared between the two groups.Results The total effective rate of the study group was significantly higher than that of the control group(95.92%vs.81.63%),and the difference was statistically significant(P<0.05).After 3 months of treatment,the HAMD,PSQI,subjective insomnia symptom score and PNN50 in both groups were decreased compared with those before treatment,moreover the study group was lower than the control;the levels of SDNN,SDANN,LF,HF and serum NPY and 5-HT were increased compared with those before treatment,moreover the study group was higher than the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(14.29%vs.10.20%,P>0.05).Conclusion EEG biofeedback combined with escitalopram could significantly improve the depressive symptoms and sleep quality in the patients with depression,regulate the autonomic nervous function and increase serum NPY and 5-HT levels.

关 键 词：脑电生物反馈 艾司西酞普兰 抑郁症 睡眠障碍 睡眠质量 自主神经功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]