【摘要】 目的:探索重复经颅磁刺激(rTMS)治疗是否可以有效提高酒依赖的戒断率,降低复发率。方法:本研究为随机双盲对照试验,即将符合入组标准的107例男性酒依赖患者随机分为两组,治疗组(n=54)接受为期4周,每周5次,共20次高频(20Hz)经颅磁刺激治疗,对照组(n=53)同样接受为期4周,每周5次,共20次的伪刺激治疗,所有患者于治疗结束后出院,随后对患者进行为期24周的随访,在每次访视中了解患者是否饮酒,以及饮酒的具体情况。结果:治疗结束后2周末、4周末治疗组和对照组复饮率、日均饮酒量、饮酒频率均有显著性差异(P均<0.05),治疗后6、8、10、12、及24周末治疗组和对照组复饮率没有显著性差异;治疗组在所有访视节点较对照组均显示复发后饮酒量更小;治疗结束后24周末,治疗组和对照组的首次复饮间隔天数、累计戒酒持续时间均有显著性差异,治疗组好于对照组(P均<0.05)。结论:高频(20Hz) rTMS治疗对男性酒依赖患者安全有效,可延长操守时间、改善治疗效果,以及降低1个月内复发率,提示康复期维持治疗对降低远期复发率可能有效。更多还原

【Abstract】 Objective: The aim of this study was to explore if repetitive transcranial magetic stimulation( rTMS) could improve the treatment outcome of alcohol-dependent inpatients and reduce the rate of relapse.Methods: A double blind,randomized controlled trial with 107 abstinent alcohol-dependent inpatients was designed and the inpatients settled in treatment-group randomly( n = 54)received 20-times high frequency( 20 Hz) r TMS,5 times every week and duration of 4 weeks totally.Other ones in control group( n = 53) also received the treatment paradigm same with treatment-group,but sham stimulation.All the patients were discharged after the whole treatment-session,and complied with the follow-up for 24 weeks.The alcohol consumption questionnaire was used to assess whether the patients relapse or not,and the status of alcohol consumption after relapse for every point of follow-up.Results: The significant differences on the rate of relapse,mean daily drinks and frequency after relapse,were showed between the treatment-group and controls at the ends of 2-week and 4-week post treatment( P < 0.05).Nonetheless,no significant difference on the rate of relapse was found at the follow-up points of 6-,8-,10-,12-,and 24- week post treatment; It is worthy to note that the daily drinks after relapse were decreased in treatment-group relative to controls at all points of follow-up,and the first time until relapse and cumulative abstinence duration were obviously longer in treatment-group than controls at the terminal of follow-up( P < 0.05).Conclusion: There are effects of high frequency( 20 Hz) rTMS for male alcohol-dependent patients to prolong the abstinence time,improve the outcome,and decrease the early recurrence rate.The possibility of decreasing long-term recurrence rate should be noted with maintained r TMS during the period of rehabilitation.更多还原