低频重复经颅磁刺激联合音乐生物反馈治疗失眠症的效果观察

Effects of low-frequency repetitive transcranial magnetic stimulation combined with music biofeedback on insomnia

目的:观察低频重复经颅磁刺激(rTMS)联合音乐生物反馈治疗失眠症的效果。方法:选取东阳市第七人民医院2021年1-8月门诊治疗的失眠患者60例为研究对象,采用随机数字表法分为观察组(n=30)和对照组(n=30)。对照组给予音乐生物反馈治疗和常规药物治疗,观察组在对照组基础上采用rTMS治疗。观察两组患者治疗前及治疗1个月后多导睡眠图(PSG)睡眠结构和匹兹堡睡眠质量指数(PSQI)评分的变化。结果:治疗1个月后,观察组总睡眠时间(TST)、睡眠效率(SE)、快动眼睡眠相(REM)、非快动眼睡眠相第二阶段(N2%)和非快动眼睡眠相第三阶段(N3%)分别为(419.87±42.63)min、(83.69±13.39)%、(25.27±3.26)%、(53.75±11.36)%、(16.27±2.25)%,对照组分别为(388.74±40.39)min、(76.38±13.17)%、(23.16±2.68)%、(51.62±12.27)%、(14.36±2.21)%,两组差异均有统计学意义(t=-2.90、-2.13、-2.22、-2.26、-3.31,P=0.005、0.037、0.030、0.027、0.002);观察组睡眠潜伏期(SL)、觉醒时间(AWT)、觉醒次数(AT)、非快动眼睡眠相第一阶段(N1%)和PSQI总评分分别为(24.16±7.82)min、(23.18±6.95)min、(1.76±0.28)次、(9.74±2.12)%、(9.17±1.56)分,对照组分别为(28.35±7.74)min、(28.36±7.21)min、(2.25±0.79)次、(11.12±1.17)%、(10.26±1.42)分,两组差异均有统计学意义(t=2.09、2.83、3.20、3.12、2.83,P=0.041、0.006、0.002、0.003、0.038)。结论:rTMS联合音乐生物反馈治疗失眠症可有效改善患者的睡眠质量。

Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)combined with music biofeedback on insomnia.Methods:Sixty patients with insomnia who received treatment in Outpatient Department of Seventh People's Hospital of Dongyang from January to August 2021 were included in this study.They were randomly divided into an observation group(n=30)and a control group(n=30)using the random number table.The control group was given music biofeedback therapy and conventional drug treatment,and the observation group was treated with rTMS based on music biofeedback therapy.The changes in polysomnography sleep structure and Pittsburgh Sleep Quality Index score after 1 month of treatment relative to before treatment were determined in each group.Results:After 1 month of treatment,the total sleep time,sleep efficiency,rapid eye movement(REM)sleep,non-REM sleep phase II(N2%)and non-REM sleep phase III(N3%)in the observation group were(419.87±42.63)minutes,(83.69±13.39)%,(25.27±3.26)%,(53.75±11.36)%and(16.27±2.25)%,respectively,and they were(388.74±40.39)minutes,(76.38±13.17)%,(23.16±2.68)%,(51.62±12.27)%,and(14.36±2.21)%,respectively.There were significant differences in these indices between the two groups(t=-2.90,-2.13,-2.22,-2.26,-3.31,P=0.005,0.037,0.030,0.027,0.002).The sleep latency,actual wake time,numbet of awakenings,non-REM sleep phase I(N1%),and total score of Pittsburgh Sleep Quality Index in the observation group were(24.16±7.82)minutes,(23.18±6.95)minutes,(1.76±0.28)times,(9.74±2.12)%,(9.17±1.56)minutes,respectively.They were(28.35±7.74)minutes,(28.36±7.21)minutes,(2.25±0.79)times,(11.12±1.17)%,and(10.26±1.42)minutes,respectively in the control group.There were significant differences in these indices between the two groups(t=2.09,2.83,3.20,3.12,2.83,P=0.041,0.006,0.002,0.003,0.038).Conclusion:rTMS combined with music biofeedback for the treatment of insomnia can effectively improve sleep quality in patients with insomnia.