重复经颅磁刺激联合右佐匹克隆片治疗脑梗死后睡眠障碍的临床研究

目的:观察重复经颅磁刺激(r TMS)联合右佐匹克隆片治疗脑梗死后睡眠障碍的临床疗效。方法:将90例脑梗死后睡眠障碍患者随机分为对照组和观察组各45例。2组均给予常规药物治疗、康复、右佐匹克隆片治疗,观察组加用rTMS治疗。2组在治疗前、治疗3周后采用匹兹堡睡眠质量指数量表(PSQI)、睡眠状况自评量表(SRSS)进行评定,并行多导睡眠监测,记录各项睡眠指标,评价患者治疗结束后的临床疗效并随访治疗结束后1月时睡眠障碍的复发情况。结果:治疗前2组的一般情况、PSQI及SRSS评分、睡眠各指标差异无统计学意义(P0.05)。治疗3周后,2组的PSQI及SRSS量表评分、睡眠潜伏期、睡眠时间、睡眠效率、觉醒次数、觉醒时间、S1%、S2%、(S3～S4)%、REM%等指标较治疗前有显著性差异(P0.01);与对照组相比,观察组的PSQI及SRSS评分、睡眠各指标有显著性差异(P0.05),有效率高于对照组(P0.05);治疗结束后1月观察组复发率低于对照组(P0.05)。结论:rTMS联合右佐匹克隆片对脑梗死后睡眠障碍患者的疗效较单用右佐匹克隆片治疗更好。

Clinical Study of Repetitive Transcranial Magnetic Stimulation Combined with DexzopicloneTablets in Treatment of Sleep Disorder in Cerebral Infarction Patients

To observe the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS)combined with dexzopiclone tablets in the treatment of sleep disorders after cerebral infarction. Methods: Total90 patients with sleep disorder after cerebral infarction were randomly divided into groups control andobservation with 45 cases in each group. Both groups were treated with routine drug therapy, rehabilitationtherapy, and dexzopiclone tablets, and the observation group was additionally treated with rTMS. Patients in bothgroups were assessed by PSQI and SRSS before treatment and 3 weeks after treatment, and polysomnographywas performed and sleep parameters recorded to evaluate the efficacy at the end of treatment. The recurrence ofsleep disorders 1 month after the end of treatment was followed up. Results: There was no significant differencein general condition, PSQI and SRSS score, and sleep parameters between the two groups before treatment (P> 0.05). Comparing data before treatment and after 3 weeks of treatment, PSQI and SRSS score, sleep latency,sleep time, sleep efficiency, wake-up frequency, wake-up time, S1% , S2% , S3-S4% , and REM% of the twogroups showed a significant difference (P<0.01). There was a significant difference in the PSQI and SRSS scoreand sleep parameters between the observation group and control group (P<0.05), and the effective rate in theobservation group was higher than that in the control group (P<0.05). One month after the end of treatment, therecurrence rate in the observation group was lower than that in the control group (P<0.05). Conclusion: rTMScombined with dexzopiclone tablets is more effective than dexzopiclone tablets alone in the treatment of sleepdisorders after cerebral infarction.