重复经颅磁刺激对酒依赖男性患者渴求及认知功能的影响

Effects of repetitive transcranial magnetic stimulation on craving for alcohol and cognitive function of male alcohol-dependent patients

摘要:

目的 探讨高频重复经颅磁刺激（rTMS）对男性酒精依赖患者渴求及认知功能的影响。方法 选取2019年3月—2019年7月新乡医学院第二附属医院住院的66例男性酒依赖患者。患者经急性期苯二氮卓类药物替代治疗后，根据随机数字表法随机分为研究组和对照组。对照组接受中等剂量选择性5羟色胺再摄取抑制药治疗，研究组另加用rTMS治疗。患者在治疗前后采用渴求自评量表及认知功能评估，后者包括简易精神状态检查量表、数字广度测验、词语流畅性测验及霍普金斯词语学习，比较两组治疗前后的改变。结果 两组年龄、受教育年限、首次饮酒年龄、累计饮酒时间及每日饮用白酒量比较，差异无统计学意义（P >0.05）。两组治疗前渴求自评及认知功能比较，差异无统计学意义（P >0.05）。研究组、对照组治疗后的渴求自评及认知功能较治疗前有改善（P <0.05）。研究组渴求自评较对照组高（P <0.05），认知功能较对照组低（P <0.05）。结论 rTMS可以降低酒依赖患者的渴求，改善认知功能。

Abstract:

Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on craving for alcohol and cognitive function in male patients with alcohol dependence.Methods Sixty-four male patients with alcohol dependence admitted to our hospital from March 2019 to July 2019 were randomly divided into study group and control group according to the random number table method after acute replacement therapy with benzodiazepines. The control group received a moderate dose of selective serotonin reuptake inhibitors (SSRIs), and the study group was additionally treated with rTMS. The patients were evaluated with the self-rating scale of craving for alcohol, and neuropsychological scales for cognitive function including Mini-Mental State Examination (MMSE), Digit Span Test (DST), Verbal Fluency Test (VFT), and Hopkins Verbal Learning Test-Revised (HVLT-R) before and after the treatment.Results There was no significant difference in age, education level, age at first alcohol use, duration of alcohol use or daily amount of alcohol use between the two groups (P > 0.05). The craving for alcohol and cognitive function were not different between the two groups before the treatment (P > 0.05), but were improved in both groups after the treatment (P < 0.05). The difference of craving for alcohol before and after the treatment was greater but that of the cognitive function before and after the treatment was lower in the study group compared with the control group (P<0.05).Conclusion The rTMS can reduce the craving for alcohol and improve cognitive function in male alcohol-dependent patients.