低频重复经颅磁刺激治疗原发性失眠症的随机对照研究

Randomized controlled trial of treatment with low-frequency repetitive transcranial magnetic stimulation for patients with primary insomnia

目的探讨低频重复经颅磁刺激治疗对原发性失眠症的效果。方法选取2015年11月~2016年11月就诊于聊城市复退军人医院精神科门诊经诊断为"原发性失眠症"的60例患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组各30例。治疗组患者给予rTMS治疗,对照组患者给予假刺激,每周治疗5次,每次20 min,共治疗20次。比较两组患者治疗前和治疗2、4周后的PSQI评分、治疗总有效率及不良反应发生情况。结果治疗前,两组患者的PSQI评分比较,差异无统计学意义(P>0.05)。治疗2、4周后,两组患者的PSQI评分均低于本组治疗前,且治疗组患者的PSQI评分明显低于对照组,差异均有统计学意义(P<0.01)。治疗组患者的治疗总有效率(96.7%)高于对照组(26.7%),差异有统计学意义(P<0.01)。两组患者治疗中不良反应发生情况比较,差异无统计学意义(P>0.05)。结论低频重复经颅磁刺激作为一种无痛、无创、经济、安全的治疗方式对治疗原发性失眠症效果显著,同时不会增加不良反应的发生。

Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation （rTMS） for patients with primary insomnia.Methods 60 patients were diagnosed with ＂primary insomnia＂ who were treated in the psychiatric department of veterans hospital in Liaocheng city from November 2015 to November 2016 were selected as subjects.The random number table method was used to divide them into treatment group and control group,30 cases in each group.The patients in the treatment group were treated with rTMS,the patients in the control group were given fake stimulus for treamnet,which were treated 5 times a week,20 min each time,20 times in total.The PSQI scores be- fore and after 2,4 weeks of treatmenLthe total efficiency of treatment and adverse reaetions were compared between the two groups.Results Before treatment,the PSQI score was compared in both groups,and the difference was not statistically significant （P〉0.05）.After 2 and 4 weeks of treatment,the PSQI scores of both groups were lower than before treatment, the PSQI scores in the treatment group were significantly lower than those in the control group,the differences were sta- tistically significant （P〈0.01）.The total treatment efficiency of patoients in the treatment group （96.7%） was higher than taht in the control group （26.7%）,the difference was statistically significant （P〈0.01）.The adverse reactions in the two groups were compared,and the difference was not statistically significant （P〉0.05）.Conclusioa The rTMS which is pain- less,non-invasive,cost-effective and safe may help to improve insomnia without increase of the adverse events.