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经颅直流电刺激治疗24 例酒精使用障碍的 疗效和安全性
许晓敏陈天真刘学兵王刚钟娜江海峰
0
()
摘要:
目的 探究经颅直流电刺激(tDCS)对酒精使用障碍患者的疗效和安全性。方法 采用随 机对照设计,选择武汉市精神卫生中心住院酒精使用障碍患者34例,按2∶1比例随机分为研究组(24例) 和对照组(10 例)。研究组接受连续10 d 的tDCS 治疗,刺激部位阳极刺激右侧背外侧前额叶皮质,阴极 刺激左侧背外侧前额叶皮质,电流强度为1.5 mA,持续20 min;对照组接受伪tDCS 治疗。干预前后采用 渴求视觉模拟评分量表(VAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质 量指数量表(PSQI)、识别任务、2-back任务、停止信号任务评估tDCS的疗效。干预期间记录患者不良反应。 结果 重复测量方差分析结果显示,HAMA 评分存在显著组别与时间交互作用(F=7.172,P=0.012)。进 一步分析发现,仅研究组患者VAS、HAMA、HAMD及工作记忆分数较干预前改善[分别为3.50(0.00,5.53) 分比5.80(3.35,10.00)分,1.00(0.00,3.00)分比5.50(1.00,9.00)分,0.00(0.00,1.00) 分比2.00(2.00,6.00)分, (1.02±0.18)比(0.84±0.20)],差异均有统计学意义(均P< 0.05),而对照组干预前后差异均无统计学 意义(均P > 0.05)。另外,干预10 d 后研究组仅HAMD 评分显著低于对照组[3.00(0.50,3.00)分],差 异有统计学意义(Z=-2.465,P=0.020)。两组患者不良反应轻微,发生率差异无统计学意义(P > 0.05)。 结论 本研究初步显示tDCS 可能对降低酒精使用障碍患者线索诱导的渴求、抑郁、焦虑及改善工作记 忆有一定的作用,未发现严重不良反应。
关键词:  酒精使用障碍  经颅直流电刺激  线索诱导的渴求  情绪  工作记忆
DOI:10.3969/j.issn.1009-6574.2020.05.002
基金项目:上海交通大学医学院多中心临床研究项目(DLY201818);上海市卫生系统优秀人才 培养计划(2017YQ013,2018YQ45);上海市科学技术委员会科研计划项目(18411961200);上海市卫 生和计划生育委员会科研课题计划(20184Y0134);上海市精神卫生中心临床研究中心重大研究计划 (CRC2018YB02)
Efficacy and safety of transcranial direct current stimulation in the treatment for 24 patients withalcohol use disorder
Xu Xiaomin, Chen Tianzhen, Liu Xuebing, Wang Gang, Zhong Na, Jiang Haifeng
()
Abstract:
Objective To explore the efficacy and safety of transcranial direct current stimulation( tDCS) on patients with alcohol use disorder( AUD). Methods A total of 34 inpatients with AUD in Wuhan Mental Health Center were selected and randomly divided into study group( 24 cases) and control group( 10 cases) at a ratio of 2∶1. The study group received 1.5 mA of tDCS over the right anode/left cathode dorsolateral prefrontal cortex for 20 minutes during ten consecutive days, while the control group received sham tDCS treatment. Visual analog scale for craving, Hamilton Depression Scale, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, Identification task, 2-back task and Stop signal task were used to assess the efficacy of tDCS before and after the intervention. The adverse reaction of patients were recorded during invention. Results Repeated-measure ANOVA showed that there was significant group and time interaction in Hamilton Anxiety Scale scores( F=7.172,P=0.012). Further analysis found that compared to the baseline, cue-induced craving, anxiety, depression and working memory were significant improved in the study group[ 3.50(0.00,5.53) vs 5.80(3.35,10.00),1.00(0.00, 3.00) vs 5.50(1.00,9.00), 0.00(0.00,1.00) vs 2.00(2.00,6.00),( 1.02±0.18) vs( 0.84±0.20), respectively,all P< 0.05] , which was not observed in the control group. Moreover, only the Hamilton Depression Scale score in the study group was lower than that of control group[ 3.00(0.50,3.00)] after 10 days of intervention, with a statistically significant difference( Z=-2.465,P=0.020).The adverse reactions were mild and the difference of rates of adverse reaction between two groups was no statistical significance. Conclusions This study preliminarily demonstrated that tDCS may play a certain role in reducing cue-induced craving, depression, and anxiety and improving working memory in patients with alcohol use disorders. Serious aduerse reactions wasn's found.
Key words:  Alcohol use disorder  Transcranial direct current stimulation  Cue-induced craving  Emotions  Working memory

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