曲唑酮联合低频重复经颅磁刺激治疗军人失眠症的临床疗效观察

目的观察曲唑酮联合低频重复经颅磁刺激（rTMS）治疗军人失眠症患者的临床疗效和不良反应。方法 48例军人失眠症患者,随机分为研究组（24例）和对照组（24例）,研究组给予曲唑酮50～100 mg,每晚一次,左侧额前回3周共15次1 Hz、80%MT的rTMS 20 min刺激;对照组给予阿普唑仑0.4～0.8 mg,每晚1次,治疗前后均行多导睡眠仪监测及临床疗效评定,应用不良反应量表（TESS）评定药物的不良反应。结果 （1）48例军人患者同治疗前相比总睡眠时间延长,睡眠效率有所提高,睡眠潜伏期明显缩短,觉醒次数明显减少（P〈0.05）;（2）研究组和对照组相比,研究组改善更为明显（P〈0.01）;（3）临床疗效比较,研究组临床痊愈率及总有效率均高于对照组（χ2=5.03,P〈0.05）,研究组不良反应发生率低于对照组（χ2=4.86,P〈0.05）。结论曲唑酮联合rTMS治疗能够改善军人失眠症患者的睡眠质量和睡眠结构,且不良反应少而轻微。

Curative Effect of Trazodone Combined with Low-frequency Repetitive Transcranial Magnetic Stimulation on Soldiers with Insomnia

Objective To explore the curative effect and adverse reactions of trazodone combined with low-frequency repetitive transcranial magnetic stimulation（rTMS） on soldiers with insomnia.Methods Forty-eight soldier patients with insomnia were divided into the observation group（n=24） and control group（n=24）.Those in observation group were treated with 50 to 100 mildigram trazodone every night and rTMS,while control group was treated with 0.4 to 0.8 milligram alprazolam every night and false-rTMS.All the patients were tested with polysomnography（PSG）,and clinical effectiveness was assessed before and after treatment.Adverse reactions were evaluated by TESS after treatment.Results（1）After 15-time treatment,the total sleep time and sleep efficiency were increased obviously（P0.05）,sleep onset latency was obviously shortened and sleep disruption times were obviously decreased in both groups.（2）There was statistically significant difference between the two groups（P0.05）.（3）Clinically,the curative rate and total effective rate in observation group were significantly higher than in control group（χ2=4.86,P0.05）,and there were fewer adverse reactions in observation group than in control group（χ2=4.86,P0.05）.Conclusion Trazodone combined with rTMS can remold sleep quality and sleep structure in soldiers with insomnia,which is a safe and effective measure.