重复经颅磁刺激治疗广泛性焦虑的对照研究

摘要

Objective To investigate the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) in patients with generalized anxiety disorder (GAD). Methods 42 GAD patients were randomly divided into two groups. Active treatment group of 22 patients received treatment with low frequency rTMS on the right parietal lobe with air-cooled coil, control group of 20 patients with low frequency rTMS on the right parietal lobe with sham coil. The treatment group and the sham group had same parameters (1 Hz, 90% of the resting motor threshold, 1500 stimuli/day) but with different coils. The Hamilton Anxiety Scale (HAMA), Hamilton depression Scale (HAMD) and Pittsburgh Sleep Quality Index (PSQI) were utilized to evaluate the therapeutic effect. Raters administered the HAMA, PSQI and HAMD scores to assess the severity of anxiety, depressive and insomnia symptoms before the first rTMS treatment, at the end of treatment, two weeks and one month after the treatment. Results HAMA, PSQI and HAMD scores differed significantly over time (p <0,05) in the active treatment group, but not in the control group. Conclusion Repetitive transcranial magnetic stimulation (rTMS) provides an effectively new therapeutic treatment in the generalized anxiety disorder.%目的 探讨重复经颅磁刺激(rTMS)对广泛性焦虑(GAD)的治疗效果.方法 选取确诊的42例广泛焦虑患者,随机分为真刺激组和假刺激组.22例患者采用真刺激线圈即风冷线圈刺激右侧顶叶,20名患者采用假刺激线圈,真刺激组和假刺激组采用的刺激参数相同(1Hz,500个刺激/串,每天共刺激三串,连续治疗10天).在治疗前、治疗结束时、治疗结束后两周和治疗结束后一个月共四次评定汉密尔顿焦虑评分(HAMA)及汉密尔顿抑郁评分(HAMD)、匹兹堡质量指数评分(PSQI)的评分变化.结果 与治疗前相比,真刺激组在治疗结束时、治疗结束后两周和治疗结束后一个月HAMA、HAMD及PSQI评分均有显著降低;假刺激组HAMA、HAMD及PSQI评分无显著改变.结论 用重复经颅磁刺激低频刺激广泛性焦虑患者的右顶叶,有显著的治疗作用,同时能改善抑郁症状和失眠症状.