重复经颅磁刺激对失眠症患者睡眠的影响

Efficacy of Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients with Primary Insomnia

目的观察重复经颅磁刺激（rTMS）对失眠症患者的临床疗效。方法将60例失眠症患者分为rTMS组和对照组,各30例。对照组每晚口服艾司唑仑1-2mg,rTMS组行rTMS治疗,均治疗14d,予多导睡眠检测仪检测治疗前后两组患者睡眠进程和睡眠结构的变化,治疗前后行匹茨堡睡眠质量指数量表（PSQI）评定,比较两组疗效。结果两组PSQI评分较治疗前均降低,差异有统计学意义（t=6.94,6.19;P〈0.05）,治疗后两组PSQI评分差异无统计学意义。治疗后两组患者的睡眠时间、睡眠潜伏期、觉醒时间、睡眠效率等较治疗前均改善,差异有统计学意义（t=2.61-7.14,P均〈0.05）;治疗后rTMS组较对照组相比,S2较短,S3和REMS较多,差异有统计学意义（t=7.09,6.32,4.61;P均〈0.05）。结论 rTMS能改善失眠症患者的睡眠质量。

Objective To explore the effect of repetitive transcranial magnetic stimulation （ rTMS） in the treatment of patients with primary insomnia.Methods 60 patients with primary insomnia were divided into 2 groups with 30 patients in each group ,one group received rTMS every day,the other group received estazolam 1-2mg every night,both groups were treated for 14 days.The effect was assessed with polysomnography and PSQI before and after treatment .Results The PSQI scores of two groups were decreased significantly after treatment than before treatment （t=6.94,6.19;P〈0.05）,there was no significant difference between rTMS group and control group（t=0.93,P〉0.93）.The total sleep time,sleep latency and awakening time and sleep efficiency of two groups were all improved significantly after treatment（t=2.61-7.14,P〈0.05）;The stage 2 sleep of the rTMS group was decreased than the control group after treatment（t=7.09,P〈0.05）.The stage 3 sleep and REMS of the rTMS group were increased than the control group after treatment （t=6.32,7.09;P〈0.05）.Conclusion rTMS can improve the quality of sleep in patients with insomnia .