重复经颅磁刺激对酒精依赖患者的疗效观察
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摘要
目的探讨重复经颅磁刺激治疗酒精依赖患者的临床效果。方法选取168例酒精依赖患者,随机分为研究组和对照组各86例,研究组接受重复经颅磁刺激治疗,对照组不接受重复经颅磁刺激治疗,共6周,于治疗前及治疗后第6周末对两组患者进行密西根酒精调查表(MAST)、抑郁自评量表(SDS)、焦虑自评量(SAS)评定,在患者出院后6个月末对两组患者进行复饮情况评定。结果治疗后第6周末,两组的MAST、SAS、SDS评分均较治疗前降低(P<0.05)。治疗后第6周末,研究组的MAST、SAS、SDS评分均低于对照组(P<0.05)。在患者出院后6个月末,研究组的复饮率低于对照组(P<0.05)。结论重复经颅磁刺激能显著改善酒精依赖患者的酒精渴求、焦虑抑郁症状,短期内降低复饮率。
Objective To explore the effects of repetitive Transcranial Magnetic Stimulation(r TMS) to treat patients with alcohol dependence.Methods A total of 168 patients with alcohol dependence were randomly divided into study group(n = 86)with r TMS and control group(n = 86) without r TMS for 6 weeks of treatment.They were assessed with Michigan Alcoholism Screening Test(MAST),Self-rating Depression Scale(SDS) and Self-rating Anxiety Scale(SAS) before treatment and at the 6~(th) weekend of treatment.They were assessed with the rate of relapse at the 6~(th) month end after their leaving hospital.Results The scores of MAST,SAS and SDS in two groups at the 6~(th) weekend of treatment were all significantly lower than those before treatment(P < 0.05).At the 6~(th) weekend of treatment,the scores of MAST,SAS and SDS in study group were all significantly lower than those in control group(P < 0.05).At the 6~(th) month end after their leaving,the rate of relapse in study group was significantly lower than that in control group(P < 0.05).Conclusion It's effective for r TMS to improve the drinking desire,anxiety and depressive symptoms of the patients with alcohol dependence,which should decrease the rate of relapse for the patients in the short-term.
Objective To explore the effects of repetitive Transcranial Magnetic Stimulation(r TMS) to treat patients with alcohol dependence.Methods A total of 168 patients with alcohol dependence were randomly divided into study group(n = 86)with r TMS and control group(n = 86) without r TMS for 6 weeks of treatment.They were assessed with Michigan Alcoholism Screening Test(MAST),Self-rating Depression Scale(SDS) and Self-rating Anxiety Scale(SAS) before treatment and at the 6~(th) weekend of treatment.They were assessed with the rate of relapse at the 6~(th) month end after their leaving hospital.Results The scores of MAST,SAS and SDS in two groups at the 6~(th) weekend of treatment were all significantly lower than those before treatment(P < 0.05).At the 6~(th) weekend of treatment,the scores of MAST,SAS and SDS in study group were all significantly lower than those in control group(P < 0.05).At the 6~(th) month end after their leaving,the rate of relapse in study group was significantly lower than that in control group(P < 0.05).Conclusion It's effective for r TMS to improve the drinking desire,anxiety and depressive symptoms of the patients with alcohol dependence,which should decrease the rate of relapse for the patients in the short-term.
引文
[1]沈渔邨.精神病学[M].6版.北京:人民卫生出版社,2009:446.
[2]刘霞燕,褚红英,孙继军.综合心理干预对酒精依赖患者复饮率影响的评价[J].中国健康教育,2014,30(9):838.
[3]Brar A,Moneta GB.Negative emotions and alcohol dependence symptoms in British Indian and White college students[J].Addict Behav,2009,34(3):292-296.
[4]江开达.精神病学[M].7版.北京:人民卫生出版社,2013:79.
[5]孙辉.安非他酮对康复期酒依赖患者疗效的对照研究[J].精神医学杂志,2015,28(4):290-292.
[6]王伟,张撰荣,吴康.嗜酒者互诫协会对酒精依赖患者的康复影响[J].中国实用神经疾病杂志,2011,14(21):41-42.
[7]Thomas P,Elias T,Dimitris K,et al.Treatment of alcohol dependence with low-dose topiramate:an open-label controlled study[J].BMC Psychiatry,2011,11(1):41.
[8]户娟.康复治疗对酒精依赖患者治疗依从性的效果观察[J].精神医学杂志,2013,26(3):212-214.
[9]李炜鋆,钟远惠,蔡丽莉,等.酒依赖患者心理防御机制、表述障碍及人格特征相关分析[J].精神医学杂志,2015,28(6):410-412.
[10]廖春平,曾志强,齐立国,等.男性住院就医来患者人格特征探讨[J].精神医学杂志,2014,27(1):33-35.
[11]陶睿,陈彬彬,王振雨,等.酒精戒断康复器男性酒依赖患者注意偏向的探究[J].精神医学杂志,2015,28(3):165-167.
[12]Kopera M,Wojnar M,Brower K,et al.Cognitive functions in abstinent alchol dependent patients[J].Alcohol,2012,46(7):665-671.
[13]胡洁,宋为群.经颅磁刺激应用于运动功能障碍的研究进展[J].中国康复医学杂志,2009,24(6):570-572.
[14]刘旭恩,沈娇.不同重复经颅磁刺激模式对精神分裂症患者认知功能及精神症状的影响[J].精神医学杂志,2016,29(1):58-59.
[15]吴迪,李锐,何珊珊,等.低频重复经颅磁刺激联合文拉法辛治疗广泛性焦虑障碍得早期疗效[J].精神医学杂志,2015,28(5):351-353.
[16]周平,张瑶,谭庆荣.重复经颅磁刺激联合帕罗西汀治疗创伤后应激障碍的疗效观察[J].精神医学杂志,2016,29(2):89-92.
[17]唐锴,叶庆红,陈志斌,等.重复经颅磁刺激辅助治疗惊恐障碍疗效观察[J].精神医学杂志,2016,29(3):212-214.
[18]韩春芳,姜登发.低频重复经颅磁刺激联合氟伏沙明控制维持期强迫症患者症状的疗效观察[J].精神医学杂志,2015,28(6):446-448.
[19]Rose JE,Mcclernon FJ,Froeliger B,et al.Repetitive transcranial magnetic stimulation of the superior frontal gyrus modulates craving for cigarettes[J].Biol Psychiatry,2011,70(8):794-799.
[20]Camprodon JA,Martinez-Raga J,Alonso MA,et al.One session of high frequency repetitive transcranial magnetic stimulation(r TMS)to the right prefrontal cortex transiently reduces cocaine craving[J].Drug Alcohol Depend,2007,86(1):331-335.
[21]朱纬国,刘书奎,刘增训.重复经颅磁刺激改善甲基苯丙胺依赖患者焦虑及心理渴求症状的对照研究[J].精神医学杂志,2015,28(4):245-247.
[22]Mishra BR,Nizamie SH,Das B,et al.Efficacy of repetitive transcranial magnetic stimulation in alcohol dependence:a sham controlled study[J].Addiction,2010,105(1):229-233.
[23]牛素英,杨林霖,邸亚丽,等.低频重复经颅磁刺激对酒依赖戒断后抑郁焦虑及睡眠状况的改善作用[J].中华行为医学与脑科学杂志,2015,24(5):184-188.
[24]Robertson EM,Theoret H,Pascual-Leone A.Studies in cognition:the problems solved and created by transcranial magnetic stimulation[J].J Cogn Neurosci,2003,15(7):948-960.
[2]刘霞燕,褚红英,孙继军.综合心理干预对酒精依赖患者复饮率影响的评价[J].中国健康教育,2014,30(9):838.
[3]Brar A,Moneta GB.Negative emotions and alcohol dependence symptoms in British Indian and White college students[J].Addict Behav,2009,34(3):292-296.
[4]江开达.精神病学[M].7版.北京:人民卫生出版社,2013:79.
[5]孙辉.安非他酮对康复期酒依赖患者疗效的对照研究[J].精神医学杂志,2015,28(4):290-292.
[6]王伟,张撰荣,吴康.嗜酒者互诫协会对酒精依赖患者的康复影响[J].中国实用神经疾病杂志,2011,14(21):41-42.
[7]Thomas P,Elias T,Dimitris K,et al.Treatment of alcohol dependence with low-dose topiramate:an open-label controlled study[J].BMC Psychiatry,2011,11(1):41.
[8]户娟.康复治疗对酒精依赖患者治疗依从性的效果观察[J].精神医学杂志,2013,26(3):212-214.
[9]李炜鋆,钟远惠,蔡丽莉,等.酒依赖患者心理防御机制、表述障碍及人格特征相关分析[J].精神医学杂志,2015,28(6):410-412.
[10]廖春平,曾志强,齐立国,等.男性住院就医来患者人格特征探讨[J].精神医学杂志,2014,27(1):33-35.
[11]陶睿,陈彬彬,王振雨,等.酒精戒断康复器男性酒依赖患者注意偏向的探究[J].精神医学杂志,2015,28(3):165-167.
[12]Kopera M,Wojnar M,Brower K,et al.Cognitive functions in abstinent alchol dependent patients[J].Alcohol,2012,46(7):665-671.
[13]胡洁,宋为群.经颅磁刺激应用于运动功能障碍的研究进展[J].中国康复医学杂志,2009,24(6):570-572.
[14]刘旭恩,沈娇.不同重复经颅磁刺激模式对精神分裂症患者认知功能及精神症状的影响[J].精神医学杂志,2016,29(1):58-59.
[15]吴迪,李锐,何珊珊,等.低频重复经颅磁刺激联合文拉法辛治疗广泛性焦虑障碍得早期疗效[J].精神医学杂志,2015,28(5):351-353.
[16]周平,张瑶,谭庆荣.重复经颅磁刺激联合帕罗西汀治疗创伤后应激障碍的疗效观察[J].精神医学杂志,2016,29(2):89-92.
[17]唐锴,叶庆红,陈志斌,等.重复经颅磁刺激辅助治疗惊恐障碍疗效观察[J].精神医学杂志,2016,29(3):212-214.
[18]韩春芳,姜登发.低频重复经颅磁刺激联合氟伏沙明控制维持期强迫症患者症状的疗效观察[J].精神医学杂志,2015,28(6):446-448.
[19]Rose JE,Mcclernon FJ,Froeliger B,et al.Repetitive transcranial magnetic stimulation of the superior frontal gyrus modulates craving for cigarettes[J].Biol Psychiatry,2011,70(8):794-799.
[20]Camprodon JA,Martinez-Raga J,Alonso MA,et al.One session of high frequency repetitive transcranial magnetic stimulation(r TMS)to the right prefrontal cortex transiently reduces cocaine craving[J].Drug Alcohol Depend,2007,86(1):331-335.
[21]朱纬国,刘书奎,刘增训.重复经颅磁刺激改善甲基苯丙胺依赖患者焦虑及心理渴求症状的对照研究[J].精神医学杂志,2015,28(4):245-247.
[22]Mishra BR,Nizamie SH,Das B,et al.Efficacy of repetitive transcranial magnetic stimulation in alcohol dependence:a sham controlled study[J].Addiction,2010,105(1):229-233.
[23]牛素英,杨林霖,邸亚丽,等.低频重复经颅磁刺激对酒依赖戒断后抑郁焦虑及睡眠状况的改善作用[J].中华行为医学与脑科学杂志,2015,24(5):184-188.
[24]Robertson EM,Theoret H,Pascual-Leone A.Studies in cognition:the problems solved and created by transcranial magnetic stimulation[J].J Cogn Neurosci,2003,15(7):948-960.