重复经颅磁刺激结合正念激励对酒精依赖戒断综合征患者负面情绪的影响

Effects of repetitive transcranial magnetic stimulation combined with mindfulness stimulation on negative emotion in patients with alcohol dependence withdrawal syndrome

目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)结合正念激励对酒精依赖戒断综合征患者负面情绪的影响。方法选取2020年3月至2021年3月丽水市第二人民医院收治的128例酒精依赖戒断综合征患者,按照随机数字表法将其分为A、B、C、D四组,每组各32例。A组患者给予常规药物干预,B组、C组患者在A组干预基础上分别给予rTMS干预和正念激励干预,D组患者在A组基础上给予rTMS结合正念激励干预。比较四组患者干预前后的改良临床机构酒精依赖戒断评估表(revised clinical institute withdrawal assessment for alcohol,CIWA-Ar)评分、宾夕法尼亚酒精渴求量表(Penn alcohol craving scale,PACS)评分、汉密尔顿抑郁量表(Hamilton depressive scale,HAMD)评分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分及复饮率、再住院率和满意度。结果干预后,四组患者的CIWA-Ar、PACS、HAMD、HAMA评分均显著低于本组干预前(P<0.05),且B、C、D组患者的上述评分均显著低于A组(P<0.05),D组患者的上述评分均显著低于B、C组(P<0.05)。D组患者的复饮率和再住院率均显著低于A组,满意度显著高于A组(P<0.05)。结论常规药物结合rTMS与正念激励干预,可有效改善酒精依赖戒断综合征患者的戒断反应和对酒精的渴求,减轻负面情绪,降低复饮率和再住院率。

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)combined with mindfulness stimulation on negative emotion in patients with alcohol dependence withdrawal syndrome.Method A total of 128 patients with alcohol dependence withdrawal syndrome admitted to Lishui Second People’s Hospital from March 2020 to March 2021 were selected and divided into four groups according to the random number table method,with 32 cases in each group.Group A was given conventional drug treatment,while group B and group C were given rTMS or mindfulness stimulation intervention on the basis of group A.Group D was given rTMS combined with mindfulness stimulation intervention on the basis of group A.The revised clinical institute withdrawal assessment for alcohol(CIWA-Ar),Penn alcohol craving scale(PACS),Hamilton depressive scale(HAMD),Hamilton anxiety scale(HAMA)were compared before and after intervention.The re-drink,re-hospitalization and satisfaction rate were compared among the four groups.Results After treatment,the CIWA-Ar scores,PACS scores,HAMD scores and HAMA scores of the four groups were lower than those before the intervention(P<0.05),and the above scores of B,C and D groups were lower than group A(P<0.05),and the above scores of group D were lower than group B and C(P<0.05).The re-drink rate and re-hospitalization rate in group D were lower than those in group A(P<0.05).The satisfaction of group D was higher than that of group A(P<0.05).Conclusion Conventional drugs combined with rTMS and mindfulness stimulation intervention can effectively improve the withdrawal reaction and alcohol craving in patients with alcohol dependence withdrawal syndrome,alleviate negative emotion,and reduce re-drink rate and re-hospitalization rate.