认知行为联合重复经颅磁刺激治疗慢性失眠症的疗效研究

COGNITIVE BEHAVIORAL THERAPY AND REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION FOR CHRONIC INSOMNIA

目的探讨CBT联合rTMS治疗慢性失眠症的临床疗效。方法将200例慢性失眠症患者随机分为合并组、认知组、磁刺激组、药物组,各50例。各组给予不同的治疗,并进行PSG、PSQI动态监测,对相应指标进行比较。结果 TST评分及SE:各组比较有统计学意义(P<0.05),合并组、认知组、刺激组评分有随时间增长而增高的趋势,合并组提高幅度高于其他2组;药物组第1周末就有显著提升且达峰值,随后有下降的趋势。SL评分:各组比较有统计学意义(P<0.05),各组均有随时间增长而降低的趋势,药物组第8周末出现反弹现象;合并组降低幅度大于其他各组。PSQI变化:各组比较有统计学意义(P<0.05),均有随时间增长而降低的趋势,合并组自治疗第2周末后即有明显降低,其他两组出现明显降低的时间较晚;药物组第1周末即出现明显降低,随后却随时间延长而出现增高现象。结论 CBT合并rTMS治疗慢性失眠症,起效快、疗效持久,无不良反应。

Objective To investigate the clinical efficacy of CBT combined with rTMS in the treatment of chronic insomnia.Methods 200 patients with chronic insomnia were randomly divided into the combined group,cognitive group,magnetic stimulation group,and drug group,50 cases each.Each group was given different treatments and dynamic monitoring of PSG and PSQI was performed and the corresponding indicators were compared.Results TST score and SE：There was a statistically significant difference between each group（P〈0.05）.The scores of the combined group,cognitive group and stimulation group increased with time,and the increase rate of the combined group was higher than that of the other two groups.The first weekend had a significant increase and peaked,followed by a downward trend.SL score：Each group was statistically significant（P〈0.05）,and each group had a tendency of decreasing with time.The drug group rebounded on the 8 th weekend;the combined group had a greater reduction than other groups.Changes in PSQI were statistically significant（P〈0.05）in each group,and all had a tendency of decreasing with time.The combined group had a significant decrease after the second weekend,and the other two groups showed a significant decrease in time later.The drug group showed a significant decrease on the first weekend,but it subsequently increased with time.Conclusion CBT combined with rTMS for the treatment of chronic insomnia has a rapid onset of efficacy and long-lasting efficacy with no adverse reactions.