重复经颅磁刺激治疗慢性失眠的疗效及认知功能、睡眠改善效果

中华养生保健 ›› 2023, Vol. 41 ›› Issue (1): 1-4.

• 论著 • 下一篇

重复经颅磁刺激治疗慢性失眠的疗效及认知功能、睡眠改善效果

陆艺¹, 王玮¹, 米国琳², 简佳³, 郑云哨⁴, 刘金同⁵

1.山东省精神卫生中心物理治疗科,山东济南,250014;
2.山东省精神卫生中心心身医学科,山东济南,250014;
3.山东省精神卫生中心精神一科,山东济南,250014;
4.山东省精神卫生中心精神五科,山东济南,250014;
5.山东省精神卫生中心儿童青少年心理行为一科,山东济南,250014

出版日期:2023-01-01 发布日期:2023-01-06
作者简介:陆艺（1977.6-）,女,汉族,籍贯：山东省济南市,硕士研究生,副主任医师,研究方向：从事精神心理领域物理治疗、心身与睡眠障碍、中西医结合专业方向的临床与研究工作。
基金资助:
山东省精神卫生中心科技发展计划项目（2019YJ02）

The Efficacy of Repeated Transcranial Magnetic Stimulation in the Treatment of Chronic Insomnia and the Improvement of Cognitive Function and Bad Mood

LU Yi¹, WANG Wei¹, MI Guo-lin², JIAN Jia³, ZHENG Yun-shao⁴, LIU Jin-tong⁵

1. Department of Physical Therapy, Shandong Mental Health Center, Jinan Shandong 250014, China;
2. Department of Psychosomatic Medicine, Shandong Mental Health Center, Jinan Shandong 250014, China;
3. Department of Psychiatry I, Shandong Mental Health Center, Jinan Shandong 250014, China;
4. Department of Psychiatry V, Shandong Mental Health Center, Jinan Shandong 250014, China;
5. Department of Psychological Behavior of Children and Adolescents I, Shandong Mental Health Center, Jinan Shandong 250014, China

Online:2023-01-01 Published:2023-01-06

摘要/Abstract

摘要： 目的探讨重复经颅磁刺激（rTMS）治疗慢性失眠的疗效及认知功能、睡眠质量、睡眠信念和态度改善效果。方法选择2019年1月~2019年12月山东省精神卫生中心收治的240例慢性失眠患者为研究对象,按随机数表法将其分为左侧背外侧前额叶皮层（DLPFC）治疗组、右侧DLPFC治疗组、中央点（Cz）后1 cm治疗组、对照组（假刺激组）,每组60例。分别在治疗前、治疗结束时使用匹兹堡睡眠质量指数（PSQI）、睡眠个人信念和态度量表（DBAS）对患者睡眠质量、睡眠信念和态度进行评价;使用蒙特利尔认知评估量表（MoCA）、符号数字转换测验（SDMT）和事件相关电位（ERPs）分别在神经心理和电生理方面对患者的认知功能进行评估。结果治疗后,左侧DLPFC治疗组、右侧DLPFC治疗组、Cz后1 cm治疗组PSQI评分低于治疗前,DBAS评分高于治疗前,差异具有统计学意义（P<0.05）;对照组PSQI、DBAS治疗前后比较,差异无统计学意义（P>0.05）;治疗后,右侧DLPFC治疗组PSQI、DBAS评分低于左侧DLPFC治疗组、Cz后1 cm治疗组,差异均具有统计学意义（P<0.05）;左侧DLPFC治疗组、右侧 DLPFC 治疗组、Cz后1 cm治疗组MoCA、SDMT评分高于治疗前,差异均具有统计学意义（P<0.05）;对照组MoCA、SDMT治疗前后比较,差异无统计学意义（P>0.05）;左侧DLPFC治疗组、右侧 DLPFC 治疗组、Cz后1 cm治疗组治疗后P3潜伏期短于治疗前,P3波幅显著大于治疗前,差异均具有统计学意义（P<0.05）;对照组P3潜伏期、P3波幅治疗前后比较,差异无统计学意义（P>0.05）。结论 rTMS可显著改善患者的认知功能、睡眠质量、睡眠信念和态度,效果显著,值得在临床应用。

关键词: 重复经颅磁刺激, 慢性失眠, 认知功能, 不良情绪, 疗效

Abstract: Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic insomnia and the improvement of cognitive function, sleep quality, sleep belief and attitude. Methods A total of 240 patients with chronic insomnia who met the inclusion criteria and were treated in the Shandong Mental Health Center from January to December 2019 were selected as the research objects. They were randomly divided into left dorsolateral prefrontal cortex (DLPFC) treatment group, right DLPFC treatment group, 1 cm behind the central point (Cz) treatment group and control group (sham stimulation group), with 60 cases in each group. Pittsburgh sleep quality index (PSQI) and sleep personal belief and attitude scale (DBAS) were used to evaluate the patients’ sleep quality, sleep belief and attitude before and at the end of treatment. The cognitive function of patients was evaluated in neuropsychological and electrophysiological aspects by Montreal Cognitive Assessment Scale (MoCA), symbol number conversion test (SDMT) and event-related potentials (ERPs). Results The PSQI scores of left DLPFC treatment group, right DLPFC treatment group and 1 cm after Cz treatment group were significantly lower than those before treatment, and the DBAS scores were significantly higher than those before treatment (P<0.05). There was no significant difference between PSQI and DBAS before and after treatment in the control group (P>0.05). The PSQI and DBAS of right DLPFC treatment group were significantly lower than those of left DLPFC treatment group and 1 cm after CZ treatment group; MoCA and SDMT in the left DLPFC treatment group, the right DLPFC treatment group and the treatment group 1 cm after CZ were significantly higher than those before treatment (P<0.05), but there was no significant difference in MoCA and SDMT before and after treatment in the control group (P>0.05); The P3 latency after treatment was significantly shorter in the left DLPFC treatment group, the right DLPFC treatment group and the treatment group 1 cm after CZ, and the P3 amplitude was significantly greater than that before treatment (P<0.05). There was no significant difference in P3 latency and P3 amplitude before and after treatment in the control group (P>0.05). Conclusion rTMS can greatly improve the cognitive function, sleep quality, sleep belief and attitude of patients, and the effect is significant. It is worthy to be applied in clinic.

Key words: repetitive transcranial magnetic stimulation, chronic insomnia, cognitive function, bad mood, curative effect

中图分类号:

R740

陆艺, 王玮, 米国琳, 简佳, 郑云哨, 刘金同. 重复经颅磁刺激治疗慢性失眠的疗效及认知功能、睡眠改善效果[J]. 中华养生保健, 2023, 41(1): 1-4.

LU Yi, WANG Wei, MI Guo-lin, JIAN Jia, ZHENG Yun-shao, LIU Jin-tong. The Efficacy of Repeated Transcranial Magnetic Stimulation in the Treatment of Chronic Insomnia and the Improvement of Cognitive Function and Bad Mood[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(1): 1-4.

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重复经颅磁刺激治疗慢性失眠的疗效及认知功能、睡眠改善效果

The Efficacy of Repeated Transcranial Magnetic Stimulation in the Treatment of Chronic Insomnia and the Improvement of Cognitive Function and Bad Mood

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