经颅磁刺激辅助治疗慢性失眠伴情绪障碍患者的社会功能及多导睡眠图观察

目的探讨经颅磁刺激(TMS)辅助治疗对慢性失眠伴情绪障碍患者的社会功能及多导睡眠图的影响。方法回顾性分析2017年1月至2019年1月84例慢性失眠伴情绪障碍患者的临床资料,按治疗方法分为两组,每组各42例,其中对照组予常规镇静安眠药物治疗,观察组在常规治疗基础上予TMS辅助治疗。比较两组治疗前后情绪障碍状况[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分]、社会功能缺陷筛选量表(SDSS)评分、多导睡眠图参数[实际睡眠总时间(TST)、睡眠潜伏期(SL)、觉醒时间(ATA)、REM潜伏期(REML)、觉醒次数(AT)、睡眠效率(SE)、睡眠维持率(SMr)、REM睡眠比例(REMSr)]以及睡眠治疗效果。结果(1)两组治疗前SAS、SDS、SDSS评分比较,差异无统计学意义(P>0.05)。治疗后,两组SAS、SDS、SDSS评分均降低,差异有统计学意义(P<0.05)。治疗后观察组SAS、SDS、SDSS评分低于对照组,差异有统计学意义(P<0.05)。(2)两组治疗前TST、SL、ATA、REML、AT、SE、SMr、REMSr比较,差异无统计学意义(P>0.05)。治疗后,两组TST、REML、SE、SMr均升高,SL、ATA、AT、REMSr均降低,差异均有统计学意义(P<0.05)。治疗后观察组TST、REML、SMr高于对照组,SL、AT、REMSr低于对照组,差异有统计学意义(P<0.05)。(3)观察组睡眠治疗总有效为92.86%,对照组为76.19%,差异有统计学意义(P<0.05)。结论TMS对慢性失眠伴情绪障碍患者疗效显著,能够明显改善患者焦虑、抑郁等情绪障碍,促进社会功能恢复正常,改善睡眠质量,值得临床推广。

Objective To explore the effects of TMS adjuvant therapy on social function and polysomnography in patients with chronic insomnia and emotional disorders.Methods A retrospective study was conducted on 84 patients with chronic insomnia with emotional disorders admitted to our hospital from January 2017 to January 2019.According to the treatment methods,they were divided into two groups,42 cases in each group.The control group was given routine sedative and sleeping drugs,while the observation group was given TMS adjuvant treatment on the basis of routine treatment.The emotional disorder status[SAS,SDS score],SDSS score,polysomnography parameters[TST,SL,ATA,REML,AT,SE,SMr,REMSr]and sleep therapeutic effect were compared between the two groups before and after treatment.Results(1)There was no significant difference in SAS,SDS and SDSS scores between the two groups before treatment(P>0.05),which was comparable.After treatment,the scores of SAS,SDS and SDSS in the two groups were decreased,and the difference was statistically significant(P<0.05).The scores of SAS,SDS and SDSS in the observation group were lower than those in the control group after treatment(P<0.05).(2)There was no significant difference in TST,SL,ATA,REML,AT,SE,SMr and REMSr between the two groups before treatment(P>0.05).After treatment,TST,REML,SE and SMr increased,while SL,ATA,AT and REMSr were decreased in both groups(P<0.05).After treatment,TST,REML and SMr in the observation group were higher than those in the control group,while SL,AT and REMSr in the observation group were lower than those in the control group(P<0.05).(3)The total effective rate of sleep therapy was 92.86%in the observation group and 76.19%in the control group,with significant difference(P<0.05).Conclusion The effect of TMS on patients with chronic insomnia and emotional disorders is significant.It can significantly improve anxiety,depression and other emotional disorders,promote social function to return to normal,improve sleep quality,and is worthy of clinical promotion.