重复经颅磁刺激治疗非器质性失眠症30例临床疗效观察

摘要

Objective:To investigate the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS)in the treatment of non organic insomnia.Methods:According to the ICD-10,select 60 cases of non organic insomnia pa-tients randomly divided into treatment group and control group,30 cases in each group,the treatment group used rTMS (stimulation site right dorsolateral prefrontal cortex area and frequency of 1 Hz stimulation,the intensity of stimulation for 100% of motor threshold,stimulation time 50 s,intermittent stimulation 5S for 1500),control group using pseudorandom stimulation treatment (the site of stimulation,frequency,time,interval,number of all is the same as the treatment group,sound vibration.However,it did not produce magnetic field effect),two groups were once daily for 2 weeks.The results of Pittsburgh sleep quality index (PSQI)and PSG were compared between the two groups before and after treat-ment.Results:In the treatment group after rTMS Pittsburgh sleep quality index (PSQI)scale scores were significantly lower than those before treatment;polysomnography showed sleep latency,wake up times and awakening time were signifi-cantly lower than that of before treatment and the control group (P <0.01).Conclusion:rTMS can effectively shorten the sleep latency time and reduce the number of awakening and shorten the time of awakening,and increasing the depth of sleep time,sleep structure of patients adjust and improve the sleep quality of patients with rTMS treatment of non organic insomnia is reliable.%目的：探讨重复经颅磁刺激（rTMS）治疗非器质性失眠症的临床疗效。方法：根据 ICD-10，选择非器质性失眠症患者60例，随机分为治疗组与对照组各30例，治疗组使用 rTMS 治疗（刺激部位为右侧前额叶背外侧区，刺激频率1 Hz，刺激强度为运动阈值的100％，刺激时间50 s，刺激间歇5 s，连续刺激1500次），对照组使用伪刺激治疗（刺激部位、频率、时间、间歇、次数都同治疗组，有振动声音，但不产生磁场效应），2组均1次／d，连续2周。对2组治疗前后的匹兹堡睡眠质量指数量表（PSQI）及多导睡眠监测（PSG）的结果进行比较。结果：治疗组患者经 rTMS 治疗后匹兹堡睡眠质量指数量表得分明显低于治疗前；多导睡眠监测显示睡眠潜伏期、觉醒次数及觉醒时间均明显少于治疗前与对照组（P ＜0.01）。结论：rTMS可有效缩短入睡潜伏期，减少觉醒次数并缩短觉醒时间，延长深睡眠时间，可改善睡眠结构，提高患者的睡眠质量，rTMS 治疗非器质性失眠症疗效可靠。