重复经颅磁刺激改善海洛因稽延性戒断综合征的研究

摘要

目的 探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)用于治疗海洛因稽延性戒断综合征的临床疗效.方法 将已经使用美沙酮替代递减脱毒12 d的138例海洛因依赖者进行随机分组,试验组接受系统的rTMS治疗,对照组接受类似rTMS的假性刺激治疗,采用稽延性戒断症状评分量表及焦虑自评量表(self-Rating anxiety scale,SAS)比较两组疗效.结果 试验组SAS评分在治疗后第5、10、15、20和30天均低于对照组(P<0.05);治疗5 d后试验组稽延性戒断症状评分低于对照组(P<0.05);出院后3个月随访调查,试验组复吸率为56.5%,对照组复吸率为89.8%,试验组复吸率低于对照组.结论 rTMS可改善海洛因依赖患者的焦虑症状与心理渴求状况,副作用小,安全性高,复吸率低.%Objective To explore the clinical effect of repetitive transcranial magnetic stimulation (rTMS)on heroin protracted withdrawal syndrome.Methods 138 cases of heroin addicts which have substituted methadone for drugs by gradual deduction for 12 days were divided randomly into the treatment group and the control group.The treatment group received the systematic treatment of rTMS,while the control group was given the sham stimulation similar to rTMS.Heroin Withdrawal Symptoms Rating Scale (HWSRS)and Self-rating Anxiety Scale (SAS)were used to investigate and compare the clinical effect of the two groups.Results The SAS scores in the treatment group were significantly lower than those in the control group after 5,10,15,20,30 days of treatment respectively (P <0.05).The HWSRS scores of the treatment group were significantly lower than those of the control group after 5 days of treatment (P <0.05).The results of 3-month follow-up investigation showed that the relapse rates of the treatment group and the control group were 56.5% and 89.8%,and the relapse rate was obviously lower in the treatment group than in the control group.Conclusion rTMS can improve the anxiety symptoms and psychological craving with few side effects,high safety and low relapse rate in patients with heroin dependence.