目的 对慢性失眠伴焦虑患者采用经颅重复磁刺激治疗,研究经颅重复磁刺激的脑血流灌注调节的机制及效果.方法 选择2022年1月-2023年1月重庆市沙坪坝区人民医院收治的70例慢性失眠伴焦虑患者,以随机抽签方法加以分组,其中对照组纳入35例患者,施行药物治疗;研究组同样纳入35例患者,行经颅重复磁刺激联合药物治疗.比较两组贝克抑郁量表、汉密尔顿焦虑量表、匹兹堡睡眠指数量表、爱泼沃斯嗜睡量表评分,以及脑血流速度、左右侧大脑半球相位差、皮肤交感反应潜伏期和波幅.结果 研究组的贝克抑郁量表、汉密尔顿焦虑量表、匹兹堡睡眠指数量表、爱泼沃斯嗜睡量表评分优于对照组,差异有统计学意义(P<0.05);对照组脑血流速度低于研究组,左右侧大脑半球相位差高于研究组,差异有统计学意义(P<0.05);研究组皮肤交感反应潜伏期和波幅低于对照组,差异有统计学意义(P<0.05);研究组失眠指数评分优于对照组,差异有统计学意义(P<0.05).结论 经颅重复磁刺激可以提高失眠焦虑患者睡眠质量,并且能够调节血流量,改善神经元代谢活动,从而缓解失眠焦虑症状,是一种有效的非药物治疗策略.
Objective To study the mechanism and effect of transcranial repetitive magnetic stimulation on cerebral blood perfusion regulation in patients with chronic insomnia and anxiety.Methods From January 2022 to January 2023,70 patients with chronic insomnia and anxiety admitted to the People's Hospital of Shapingba District,Chongqing City were selected and grouped by random lottery.Among them,35 patients were included in the control group and treated with drugs.The study group also included 35 patients who underwent transcranial repetitive magnetic stimulation combined with drug therapy.The scores of Beck Depression Scale,Hamilton Anxiety Scale,Pittsburgh Sleep Index Scale,Epworth Sleepiness Scale,cerebral blood flow velocity,phase difference between left and right cerebral hemispheres,skin sympathetic response latency and amplitude were compared between the two groups.Results The scores of Beck Depression Scale,Hamilton Anxiety Scale,Pittsburgh Sleep Index Scale and Epworth Sleepiness Scale in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).The cerebral blood flow velocity of the control group was lower than that of the study group,and the phase difference between the left and right cerebral hemispheres was higher than that of the study group,the differences were statistically significant(P<0.05).The skin sympathetic response latency and amplitude of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).The insomnia index score of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Repetitive transcranial magnetic stimulation can improve the sleep quality of patients with insomnia and anxiety,regulate blood flow,improve neuronal metabolic activity,and alleviate insomnia and anxiety symptoms,which is an effective non-drug treatment strategy.