陈妙　周海云　夏朝云

[摘要] 目的 分析酒石酸唑吡坦片联合1 Hz重复经颅磁刺激治疗失眠症的临床疗效。 方法 选择2016年1～10月在我院治疗的失眠症患者120例为研究对象，随机分为研究组与对照组各60例。研究组采用重复经颅磁刺激联合酒石酸唑吡坦片治疗；对照组给予酒石酸唑吡坦片治疗。比较两组治疗前及治疗后2周采用匹兹堡睡眠质量指数（PSQI）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分，比较两组临床疗效。 结果 治疗后两组PSQI总分及各维度得分均显著较治疗前改善，差异有统计学意义（P<0.05）；治疗后研究组PSQI总分及各维度得分均显著低于对照组，差异有统计学意义（P<0.05）。治疗后，两组HAMA及HAMD评分均显著低于治疗前，差异有统计学意义（P<0.05）；治疗后，研究组HAMA及HAMD评分均显著低于对照组，差异有统计学意义（P<0.05）。研究组总有效率显著高于对照组，差异有统计学意义（P<0.05）。两组患者不良反应发生率比较差异无统计学意义（P>0.05）。 结论 酒石酸唑吡坦片联合1Hz重复经颅磁刺激治疗失眠症能够显著提高临床疗效，改善患者睡眠质量，缓解患者焦虑抑郁情况。

[关键词] 重复经颅磁刺激；失眠症；酒石酸唑吡坦片；采用匹兹堡睡眠质量指数；汉密尔顿焦虑量表；汉密尔顿抑郁量表

[中图分类号] R740 [文献标识码] B [文章编号] 1673-9701（2017）16-0080-04

[Abstract] Objective To analyze the effect of zolpidem tartrate tablets combined with 1Hz rTMS in the treatment of insomnia. Methods 120 cases with insomnia from January to October 2016 were selected and randomly divided into study group and control group， each of 60 cases. Study group was treated with 1Hz rTMS combined with zolpidem tartrate tablets. and control group was treated with zolpidem tartrate tablets. PSQI， HAMA and HAMD scores of two groups before treatement and two weeks after treatment were compared. The clinical efficacy of two groups was compared. Results After treatment， PSQI total score and dimension scores of two groups were lower than those before treatment， The differences were statistically significant（P<0.05）； After treatment， PSQI total score and dimension scores of study group were lower than those of the control group， The differences were statistically significant（P<0.05）. After treatment， HAMA and HAMD scores of two groups were lower than those before treatment， The differences were statistically significant（P<0.05）； After treatment， HAMA and HAMD scores of study group were lower than those of the control group， The differences were statistically significant （P<0.05）. The total effective rate of study group was higher than that of the control group， The difference was statistically significant（P<0.05）. The difference was no statistically significant of adverse reaction rate between groups（P>0.05）. Conclusion Zolpidem tartrate tablets combined with 1Hz rTMS in the treatment of insomnia can improve clinical efficacy， improve sleep quality， and relief anxiety and depression.

[Key words] rTMS； insomnia； Zolpidem tartrate tablets； PSQI； HAMA； HAMD

失眠癥是一种生理障碍，是常见的睡眠障碍，患者持续睡眠质量不能令人满意，患者可出现忧虑、恐惧等心理，成为主要的致病心理因素。失眠症发病因素包括环境、躯体、神经精神疾病等。失眠症严重影响患者的工作和生活[1，2]。重复经颅磁刺激是通过线圈产生高磁通量磁场无衰减地穿过颅骨，对神经结构产生刺激作用，临床上用于治疗抑郁症、焦虑障碍、改善患者记忆力及认知功能等[3]。临床上也将其用于失眠症的治疗。我们采用酒石酸唑吡坦片联合1Hz频率的经颅磁刺激治疗失眠症，取得了较好的效果，现报道如下。……