中国康复理论与实践 ›› 2022, Vol. 28 ›› Issue (12): 1466-1472.doi: 10.3969/j.issn.1006-9771.2022.12.012

• 应用研究 • 上一篇    下一篇

经颅直流电刺激对卒中后失眠的疗效

顾彬1,2,黄富表1,2,李泓钰3,宋鲁平1,4()   

  1. 1.首都医科大学康复医学院,北京市 100068
    2.中国康复研究中心北京博爱医院,北京市 100068
    3.宁夏医科大学总医院,宁夏银川市 750003
    4.深圳大学总医院,广东深圳市 518071
  • 收稿日期:2022-08-11 修回日期:2022-11-08 出版日期:2022-12-25 发布日期:2023-01-10
  • 通讯作者: 宋鲁平 E-mail:songluping882002@aliyun.com
  • 作者简介:顾彬(1986-),男,汉族,山东滨州市人,硕士研究生,主管技师,主要研究方向:神经康复、认知神经科学、康复治疗。|宋鲁平(1964-),女,汉族,主任医师,教授,博士研究生导师,主要研究方向:神经康复、认知神经科学。
  • 基金资助:
    中国康复研究中心项目(2019ZX-Q2)

Effect of transcranial direct current stimulation on post-stroke insomnia

GU Bin1,2,HUANG Fubiao1,2,LI Hongyu3,SONG Luping1,4()   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
    2. Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
    3. Ningxia Medical University General Hospital, Yinchuan, Ningxia 750003, China
    4. Shenzhen University General Hospital, Shenzhen, Guangzhou 518071, China
  • Received:2022-08-11 Revised:2022-11-08 Online:2022-12-25 Published:2023-01-10
  • Contact: SONG Luping E-mail:songluping882002@aliyun.com
  • Supported by:
    China Rehabilitation Research Center Project(2019ZX-Q2)

摘要:

目的 观察经颅直流电刺激(tDCS)对卒中后失眠(PSI)患者睡眠及情绪的影响。

方法 2020年1月至2021年5月,北京博爱医院神经康复中心PSI患者44例随机分为对照组(n = 22)和试验组(n = 22)。在常规治疗基础上,试验组采用tDCS治疗,对照组采用假刺激治疗,共4周。治疗前后采用匹兹堡睡眠质量指数量表(PSQI)、基于心肺耦合技术的睡眠监测系统评估患者睡眠质量;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估患者情绪。

结果 两组各脱落2例。治疗后,两组PSQI、HAMA、HAMD评分均显著低于治疗前(t > 8.575, P < 0.001),试验组PSQI、HAMA评分明显优于对照组(t > 2.811, P < 0.01),两组间HAMD评分无显著性差异(t = 1.756, P > 0.05);两组睡眠质量指数、睡眠总时间、睡眠潜伏期、睡眠效率、觉醒转换次数均显著优于治疗前(|t| > 4.721, P < 0.001),试验组快速眼动期时间优于治疗前(t = -2.851, P = 0.010);试验组睡眠质量指数、睡眠总时间、睡眠效率、觉醒转换次数均优于对照组(|t| > 2.190, P < 0.05),但睡眠潜伏期、快速眼动期时间改善不明显(|t| < 1.073, P > 0.05)。

结论 tDCS可以改善PSI患者睡眠质量和焦虑情绪,对睡眠结构影响不大。

关键词: 卒中后失眠, 经颅直流电刺激, 焦虑, 抑郁, 康复

Abstract:

Objective To observe the effects of transcranial direct current stimulation (tDCS) on insomnia, anxiety and depression in patients with post-sroke insomnia (PSI).

Methods From January, 2020 to May, 2021, 44 patients with PSI from Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and experimental group (n = 22). On the basis of conventional treatment, the experimental group accepted tDCS, and the control group accepted sham stimulation for four weeks. Pittsburgh Sleep Quality Index (PSQI) and sleep monitoring system based on cardiopulmonary coupling technology were used to evaluate the sleep quality of the patients before and after treatment. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate mood.

Results Two cases dropped out in each group. After treatment, the scores of PSQI, HAMA and HAMD decreased in both groups (t > 8.575, P < 0.001), and the scores of PSQI and HAMA were better in the experimental group than in the control group (t > 2.811, P < 0.01), however, there was no significant difference in the scores of HAMD between two groups (t = 1.756, P > 0.05). After treatment, the sleep quality index, total sleep time, sleep latency, sleep efficiency and wake conversion times improved (|t| > 4.721, P < 0.001), and the rapid eye movement time prolonged in the experimental group (t = -2.851, P = 0.010); the sleep quality index, total sleep time, sleep efficiency and wake conversion times were better in the experimental group than in the control group (t > 2.190, P < 0.05), however, no significant difference was found in the sleep latency and rapid eye movement time between two groups (|t|< 1.073, P > 0.05).

Conclusion tDCS could improve the sleep quality and anxiety in PSI patients, and has little effect on sleep structure.

Key words: post-sroke insomnia, transcranial direct current stimulation, anxiety, depression, rehabilitation

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