米氮平联合rTMS治疗伴睡眠障碍的老年焦虑症疗效观察

Observation On the efficacy of mirtazapine combined with rTMS in elderly anxiety patients with sleep disorder

目的探讨应用米氮平联合经颅重复磁刺激法(rTMS)治疗伴睡眠障碍的老年焦虑症患者的临床效果。方法选取本院收治的200例老年焦虑症伴失眠症的患者依据入院顺序分为联合组(米氮平+rTMS)和对照组(单用米氮平)各100例,2组患者均治疗8周时间,对比临床效果。结果治疗后联合组的PSQI量表7因子(睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能)及PSQI总分均显著低于对照组各因子评分及总分,差异均具有统计学意义(P<0.05)。治疗后联合组PSG睡眠进程参数(睡眠潜伏期、REM潜伏期、总睡眠时间、睡眠效率、觉醒次数)显著优于对照组,差异均具有统计学意义(P<0.05)。联合组治疗后SAS评分低于对照组(P<0.05)。治疗后联合组愈显率(47.00%)显著高于对照组(32.00%)(P<0.05)。结论米氮平+rTMS治疗伴睡眠障碍的老年焦虑症患者较单用米氮平具有更显著的临床效果。

Objective To explore the clinical efficacy of mirtazapine combined with repetitive transcranial magnetic stim‐ulation（rTMS） in elderly anxiety patients with sleep disorder .Methods Two hundred elderly cases with both anxiety and sleep disorder were divided into combination group （mirtazapine＋rTMS） and control group（only mirtazapine） according to the order of admission ,each group had 100 cases .Two group received treatment for eight weeks and then clinical efficacies of two groups were compared .Results After treatment ,both the PSQI scale containing seven factors （sleep quality ,onset time ,sleep time ,sleep efficiency ,sleep disturbance ,hypnotic drug and daytime function） and PSQI scores（2.14± 2.39） in the combination group ,were significantly lower than those in the control group ,and all differences were statistically significant （P〈0.05） .Af‐ter treatment ,the values of PSG sleep parameters（sleep latency ,REM latency ,total sleep time ,sleep efficiency ,awake times） in the combination group were significantly better than those in the control group ,with statistically significant differences （P〈0.05） .Compared with control group ,the combination group held less SAS scores .Additionally ,the curative rate in the combi‐nation group（47% ） was obviously higher than that in the control group（32% ） .Conclusion The therapy of mirtazapine com‐bined with rTMS can more effectively improve clinical efficacy .