高频重复经颅磁刺激、舍曲林对酒精依赖急性戒断期的应用价值

Application value of high-frequency repetitive transcranial magnetic stimulation and Sertraline in the acute withdrawal period of alcohol dependence

目的探讨高频重复经颅磁刺激联合舍曲林在男性酒精依赖患者急性戒断期治疗中的应用价值,以期改善患者精神状态、生活质量。方法选取2019年7月至2021年10月安阳市第七人民医院收治的108例男性酒精依赖急性戒断期后患者,采用随机数字表将患者分为两组,参照组、联合组各54例。参照组采用舍曲林治疗,联合组采用高频重复经颅磁刺激联合舍曲林治疗。比较两组临床疗效、治疗前后汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表17项版(HAMD-17)评分、宾夕法尼亚酒精渴求量表(PACS)评分、简明酒精戒断症状评定量表(AWS)评分、血清氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)]、血清神经递质水平[去甲肾上腺素(NE)、5-羟色胺(5-HT)、多巴胺(DA)、摄食素(Orexin)]、治疗后3个月、6个月复饮情况。结果两组临床总有效率比较,联合组(90.74%)高于参照组(75.93%),P<0.05;治疗后联合组HAMA、HAMD-17、AWS、PACS评分降低幅度大于参照组(P<0.05);与治疗前相比,各组治疗后SOD、GSH-Px活性明显升高,MDA水平明显降低,联合组更为显著(P<0.05);与参照组相比,治疗后联合组血清NE、5-HT、Orexin水平明显降低,DA水平明显升高(P<0.05);联合组治疗后3个月、6个月复饮率低于参照组(P<0.05)。结论高频重复经颅磁刺激联合舍曲林治疗男性酒精依赖急性戒断期患者效果确切,能有效缓解患者负面心理情绪,改善机体氧化应激状态、神经递质水平,从而减少复饮情况发生。

Objective To explore the value of high-frequency repetitive transcranial magnetic stimulation combined with Sertraline in the treatment of male alcohol-dependent patients during acute withdrawal period,in order to improve their mental state and quality of life.Methods From July 2019 to October 2021,108 male patients with alcohol dependence after the acute withdrawal period were selected from the Seventh People's Hospital of Anyang City.The patients were divided into two groups by the random number table,54 in the reference group and 54 in the combined group.The reference group was treated with Sertraline,and the combined group was treated with high-frequency repetitive transcranial magnetic stimulation combined with Sertraline.They were compared in terms of clinical efficacy of the two groups,Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD-17),Penn alcohol craving scale(PACS)score,concise alcohol withdrawal syndrome(AWS),serum oxidative stress index[glutathione peroxidase(GSH-Px),malondialdehyde(MDA),superoxide dismutase(SOD)],serum neurotransmitter level[norepinephrine(NE),5-hydroxytryptamine(5-HT)Dopamine(DA),Orexin(Orexin)],and the status of relapse at 3 and 6 months after treatment.Results Comparison of total clinical effective rates between the two groups showed the combined group(90.74%)was higher than the control group(75.93%),P<0.05;After treatment,the scores of HAMA,HAMD-17,AWS and PACS in the combined group were significantly lower than those in the reference group(P<0.05);Compared with before treatment,the activities of SOD and GSH-Px in each group increased significantly after treatment,and the level of MDA decreased significantly,especially in the combined group(P<0.05);Compared with the reference group,the levels of NE,5-HT and Orexin in the serum of the combined group were significantly lower and the levels of DA were significantly higher(P<0.05);The relapse rate in the combined group was lower than that in the reference group at 3 and 6 months after treatment(P<0.05).Conclusion High frequency repetitive transcranial magnetic stimulation combined with Sertraline is effective in the treatment of male alcohol-dependent patients during acute withdrawal period,which can effectively relieve the negative psychological mood of the patients,improve the oxidative stress state of the body and the level of neurotransmitter,thus reducing the occurrence of relapse.