文章摘要
胡树罡,沈滢,顾晓美,管重远,莫非.低频重复经颅磁刺激治疗老年人失眠症的疗效观察[J].中华物理医学与康复杂志,2018,40(3):187-190
低频重复经颅磁刺激治疗老年人失眠症的疗效观察
Repeated low-frequency transcranial magnetic stimulation can relieve insomnia
  
DOI:
中文关键词: 老年  失眠症  经颅磁刺激  交变磁场  DLPFC
英文关键词: Elderly  Insomnia  Transcranial magnetic stimulation  Alternating magnetic fields  Prefrontal cortex
基金项目:江苏省老年医学研究所基金项目(L201406)
作者单位
胡树罡,沈滢,顾晓美,管重远,莫非 210024 南京江苏省老年医院(胡树罡、顾晓美、管重远、莫非)南京医科大学康复医学院(沈滢) 
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中文摘要:
      目的 观察低频重复经颅磁刺激(rTMS)对失眠症老年人睡眠和情绪的影响。 方法 选取34例失眠症老年患者,按照随机数字表法将其分为试验组(18例)和对照组(16例)。试验组采用低频rTMS刺激右背外侧前额叶皮质(DLPFC)治疗,对照组给予交变磁场治疗。治疗前及治疗4周后(治疗后),使用匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对患者进行评估。为了消除睡眠变化对患者HAMA和HAMD评分的影响,对此两项评分去除睡眠相关项得分后的分值(标记为HAMA-A、HAMD-A)进行评估。 结果 治疗前,2组患者的PSQI、HAMA和HAMD评分比较,差异无统计学意义(P>0.05)。治疗后,试验组与对照组患者的PSQI、HAMA、HAMD评分均明显下降(P<0.05),且试验组PSQI[(8.44±1.82)分]、HAMA[(10.66±2.59)分]、HAMD[(11.78±3.64)分]较对照组低,差异有统计学意义(P<0.05)。除去HAMA与HAMD的睡眠相关选项得分后,试验组患者治疗后HAMA-A、HAMD-A较组内治疗前低(P<0.05),对照组患者治疗后HAMA-A、HAMD-A虽较组内治疗前低,但差异无统计学意义(P>0.05)。试验组患者治疗后HAMA-A[(11.11±2.72)分]、HAMD-A[(10.17±3.28)分]较对照组低(P<0.05)。 结论 rTMS治疗老年失眠症的疗效优于交变磁场,能显著改善患者睡眠和情绪。
英文摘要:
      Objective To observe any effect of low-frequency transcranial magnetic stimulation (rTMS) on the sleep and mood of elderly insomniacs. Methods Thirty-four elderly insomniacs were divided randomly into an experiment group (n=18) and a control group (n=16). The experiment group received rTMS of the right dorsolateral prefrontal cortex, while the control group was given alternating magnetic field stimulation at the same site. Before and after 4 weeks of the treatments, all of the subjects were assessed using the Pittsburgh sleep quality index (PSQI), the Hamilton anxiety scale (HAMA) and the Hamilton depression scale (HAMD). They were also assessed with those instruments omitting the sleep items in order to reduce the possible impact of any sleep changes on the HAMA and HAMD scores. Results Before the treatment there were no significant differences in the groups′ average PSQI, HAMA and HAMD scores. After 4 weeks all the measurements in both groups had decreased significantly, with the experimental group′s averages significantly lower than those of the control group. Conclusions rTMS treatment is more effective than alternating magnetic field treatment for the elderly with insomnia, significantly improving their sleep and mood.
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