重复经颅磁刺激治疗伴有失眠的焦虑症38例临床观察

目的探讨重复经颅磁刺激（repetitivetranscranialmagneticstimulation，rTMS）治疗伴有失眠的焦虑症患者临床疗效。方法伴有失眠的焦虑症患者76例，随机分为rTMS组与对照组各38例，rTMS组采用rTMS刺激＋文拉法辛治疗，对照组采用伪线圈rTMS刺激＋文拉法辛治疗，2组患者均刺激1次／d，20min／次，连续7d。比较2组治疗前、后汉密尔顿焦虑量表、多导睡眠监测睡眠潜伏期、觉醒次数及觉醒时间。结果rTMS组患者治疗后汉密尔顿焦虑量表明显低于治疗前与对照组（P〈0．01）；多导睡眠监测睡眠潜伏期、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可明显改善伴有失眠焦虑症患者的不良焦虑情绪，有效缩短睡眠潜伏期时间，减少觉醒次数及觉醒时问，rTMS治疗伴失眠焦虑症患者疗效可靠。

Clinical observation of repetitive transcranial magnetic stimulation in the treatment of anxiety insomnia in 38 patients

Objective To investigate the effect of repetitive transcranial magnetic stimulation （rTMS） on anxiety insomnia. Methods Seventy-six patients with anxiety insomnia were randomly divided into rTMS group and control group, with 38 patients in each group, rTMS group received rTMS therapy plus oral administration of venlafaxine, and control group received pseudo-coil rTMS plus oral administration of venlafaxine, for 20 minutes each time, once a day, totally for 7 days. Hamilton Anxiety Scale （HAM-A）, sleep latency, number of awakening and awakening time on polysomnography （PSG） were evaluated and compared before and 1 week after treatment between two groups. Results HAM-A was significantly lower, and the sleep latency and awakening time on PSG were shorter and number of awakening was significantly less after treatment than those before treatment in rTMS group and than those in control group, respectively （P〈0.01）. Conclusions rTMS can significantly relieve anxiety, effectively shorten the sleep latency time and awakening time, and reduce the number of awakening in the patients with anxiety insomnia. It is reliable and effective for rTMS to treat anxiety insomnia.