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重复经颅磁刺激对甲基苯丙胺依赖者的疗效 及安全性
刘璐颖许华山焦东亮高贺程晓东王立金沐林林
0
()
摘要:
目的 探讨高频重复经颅磁刺激(rTMS)对甲基苯丙胺(MA)依赖者戒断后焦虑、抑郁及渴 求的疗效及安全性评价。方法 采用随机对照研究,前瞻性选取蚌埠强制隔离戒毒所戒毒的男性MA依 赖者47 例,将所有被试者按随机数字表法分为研究组和对照组,研究组接受系统的高频(10 Hz)rTMS 治 疗,对照组接受rTMS 的伪刺激治疗,每周3 次,共治疗4 周。在基线时和治疗第4 周末分别应用焦虑自 评量表(SAS)、抑郁自评量表(SDS)和视觉模拟标尺(VAS)评定患者的焦虑、抑郁和心理渴求情况,干预 期间采用不良反应问卷记录出现的不良反应。结果 治疗第4周末,研究组SAS评分[(43.17±8.60)分]、 SDS 评分[(48.00±8.12)分]和VAS 评分[1.00(0,2.75)分]较基线时SAS 评分[(46.71±8.64)分]、SDS 评分[(52.96±7.66)分]和VAS 评分[4.00(2.00,5.75)分]降低,差异均有统计学意义(均P< 0.05),且低 于对照组[分别为(48.74±8.92)、(53.13±6.61)、4.00(0,6.00)分],差异均有统计学意义(均P< 0.05)。对 照组治疗第4 周末SAS、SDS 评分及VAS 评分与基线时比较,差异均无统计学意义(均P> 0.05)。研究组 8 例(33.33%)患者发生不良反应,其中头痛6 例,头晕1 例,耳鸣1 例,患者均可耐受;对照组患者未发生 不良反应事件。结论 高频rTMS 可改善MA 依赖者的焦虑、抑郁及渴求情况,轻微不良反应发生较为 普遍。
关键词:  重复经颅磁刺激  甲基苯丙胺  安全性  焦虑  抑郁
DOI:10.3969/j.issn.1009-6574.2020.11.011
基金项目:蚌埠医学院研究生科研创新计划项目(Byycx1943);安徽高校自然科学研究重点项目 (KJ2018A1017);蚌埠医学院科技发展基金(BYKF1818)
Efficacy and safety evaluation of repetitive transcranial magnetic stimulationthe in methamphetaminedependent patients
Liu Luying, Xu Huashan, Jiao Dongliang, Gao He, Cheng Xiaodong, Wang Lijin, Mu Linlin
()
Abstract:
Objective To investigate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation( rTMS) in the treatment of post-withdrawal anxiety, depression and hunger in methamphetamine( MA) dependent patients. Methods A total of 47 cases of male MA dependent detoxification patients in Bengbu Compulsory Isolation and Rehabilitation Center were prospectively selected. All the subjects were divided into study group and control group according to the random number table method. The study group received systematic high-frequency( 10 Hz) rTMS treatment, while the control group received sham rTMS treatment for 3 times a week and a total of 4 weeks. Self-rating Anxiety Scale( SAS), Self-rating Depression Scale( SDS) and Visual Analogue Scale( VAS) were used to assess anxiety, depression and psychological craving at baseline and at the end of the fourth week of treatment, respectively. Adverse drug reactions were recorded by adverse drug reactions questionnaire( ADR) during the intervention. Rusults At the end of the fourth week of treatment, SAS score( 43.17±8.60), SDS score( 48.00±8.12) and VAS score[ 1.00( 0,2.75)] in the study group were lower than those at baseline[ SAS score( 46.71±8.64), SDS score( 52.96±7.66) and VAS score 4.00( 2.00,5.75)]with statistically significant differences( all P<0.05). SAS score, SDS score and VAS score of the study group at the end of the fourth week of treatment were all lower than those of the control group[ (48.74±8.92), SDS scores( 53.13±6.61) and VAS scores 4.00(0, 6.00)]with statistically significant differences( P <0.05). There was no statistically significant difference in SAS, SDS and VAS scores of the control group at the end of the fourth week compared with those at baseline( all P>0.05). There were 8 cases (33.33%) of adverse reactions in the study group, including 6 cases of headache, 1 case of dizziness and 1 case of tinnitus, which could be tolerated by the patients; no adverse reactions occurred in the control group. Conclusions High-frequency rTMS can improve the anxiety, depression and craving of methamphetaminedependent patients. Mild adverse reactions are common.
Key words:  Repetitive transcranial magnetic stimulation  Methamphetamine  Safety  Anxiety  Depression

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