重复经颅磁刺激对酒依赖者的影响

Effects of repeated transcranial magnetic stimulation on alcohol-dependent patients

目的:研究重复经颅磁刺激(rTMS)对酒依赖者心理渴求、自我效能感(SE)及复饮的影响。方法:选择2021年4月~2022年6月于我院接受治疗的酒依赖患者86例,依据随机数字表法将86例酒依赖患者分为rTMS组(n=43)、对照组(n=43)。对照组行常规支持及替代治疗,rTMS组在对照组基础上行rTMS治疗。观察2组治疗前、治疗5周后及治疗后6个月酒精依赖、心理渴求、自我效能感及复饮情况;观察2组治疗后6个月,复饮以及再住院情况。结果:治疗完成后,2组酒精依赖戒断评估表(CIWA-Ar)、酒精依赖筛查量表(MAST)、心理渴求以匹兹堡睡眠质量指数量表(PSQI)、宾夕法尼亚酒精渴求量表(PACS)评分均较治疗前降低(P<0.05),且rTMS组CIWA-Ar、MAST、PSQI、PACS评分均低于对照组(P<0.05);治疗后6个月,rTMS组CIWA-Ar、MAST、PSQI、PACS评分均低于对照组(P<0.05),rTMS组CIWA-Ar、MAST、PSQI、PACS评分与治疗完成后差异无统计学意义,对照组CIWA-Ar、MAST、PSQI、PACS评分均高于治疗完成后(P<0.05)。治疗完成后,2组一般自我效能感量表(GSES)评分均较治疗前升高,且rTMS组GSES评分均高于对照组(P<0.05);治疗后6个月,rTMS组GSES评分高于对照组(P<0.05),rTMS组GSES评分与治疗完成后差异无统计学意义,对照组GSES评分低于治疗完成后(P<0.05)。治疗期间,2组均无显著副反应发生。治疗后6个月,rTMS组复饮以及再住院率均低于对照组(P<0.05)。结论:rTMS治疗可有助于降低酒依赖患者酒精依赖程度及对酒精的心理渴求,缓解患者生理心理上的痛苦,增强其SE,降低复饮及再住院率。

Objective:To study the effects of repeated transcranial magnetic stimulation(rTMS)on psychological craving,self-efficacy and relapse of alcohol dependence.Methods:A total of 86 alcohol-dependent patients treated in our hospital from April 2021 to June 2022 were selected and divided into rTMS group(n=43)and control group(n=43)by the random number table method.The control group received routine support and alternative therapy,and the rTMS group received rTMS therapy on the basis of the control group.Alcohol dependence,psychological craving,self-efficacy and relapse were observed before treatment,after treatment and 6 months after treatment.Relapse and re-hospitalization after 6 months of treatment were observed in both groups.Results:After treatment,CIWA-Ar,MAST,PSQI and PACS scores in both groups were lower than those before treatment,and CIWA-Ar,MAST,PSQI and PACS scores in the rTMS group were lower than those in the control group.After 6 months of treatment,CIWA-Ar,MAST,PSQI and PACS scores in the rTMS group were lower than those in the control group(P<0.05).CIWA-Ar,MAST,PSQI and PACS scores in the rTMS group were not different from those after treatmen,while CIWA-Ar,MAST,PSQI and PACS scores in the control group were higher than those after treatment.After treatment,GSES scores in both groups were higher than those before treatment,and GSES scores in the rTMS group were higher than those in the control group.After 6 months of treatment,GSES score in the rTMS group was higher than that in the control group(P<0.05).There was no significant difference in the GSES scores in the rTMS bctween 6 months of treatment and after treatment completion,while the GSES scores in the control group were lower than those after treatment.During treatment,no significant side effects occurred in both groups.After 6 months of treatment,the rates of re-drinking and re-hospitalization in rTMS group were lower than those in the control group(P<0.05).Conclusion:rTMS can help reduce the degree of alcohol dependence and psychological thirst for alcohol,relieve the physiological and psychological pain of patients,enhance their SE,and reduce the rate of relapse and re-hospitalization.