重复经颅磁刺激联合乌灵胶囊治疗脑梗死后抑郁伴失眠的效果OA
Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Wul-ing Capsule in the Treatment of Post-Stroke Depression Complicated by In-somnia
目的 探讨重复经颅磁刺激(rTMS)联合乌灵胶囊治疗脑梗死后抑郁伴失眠的效果.方法 选取2023年10月至2024年3月本院收治的70例脑梗死后抑郁伴失眠患者为对象,采用随机数字表法分为对照组与研究组.对照组采用乌灵胶囊治疗,研究组采用乌灵胶囊联合rTMS治疗.比较两组的临床疗效、神经递质水平、情绪及睡眠指标、影像学指标以及不良反应.结果 研究组的总有效率高于对照组(P＜0.05).与治疗前相比,治疗后两组的5-HT、DA、NE水平升高,且研究组的5-HT、DA、NE水平高于对照组(P＜0.05).与治疗前相比,治疗后两组的HAMD-17、PSQI评分降低,睡眠效率提高,且研究组的变化幅度高于对照组(P＜0.05).与治疗前相比,治疗后两组的左侧大脑中动脉、左侧大脑前动脉及基底动脉血流速度升高,且研究组的左侧大脑中动脉、前动脉及基底动脉血流速度高于对照组(P＜0.05).两组的不良反应发生率比较,差异无统计学意义(P＞0.05).结论 rTMS联合乌灵胶囊治疗脑梗死后抑郁伴失眠效果显著,其协同增效机制与单胺递质上调、脑灌注改善及睡眠结构重塑的多层次互补效应相关,且安全性良好.
Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with Wuling Capsule in the treatment of post-stroke depression complicated by insomnia.Methods A total of 70 patients with post-stroke depression complicated by insomnia admitted to our hospital from October 2023 to March 2024 were selected as subjects and divided into the control group and the study group using a random number table method.The control group was treated with Wuling Capsule,while the study group was treated with Wuling Capsule combined with rTMS.The clinical efficacy,neurotransmitter levels,emotional and sleep indicators,imaging indicators,and adverse reactions were compared between the two groups.Results The total effective rate of the study group was significantly higher than that of the control group(P＜0.05).Compared with pre-treatment,the levels of 5-HT,DA,and NE increased in both groups after treatment,and the levels of 5-HT,DA,and NE after treatment in the study group were significantly higher than those in the control group(P＜0.05).Compared with pre-treatment,the HAMD-17 and PSQI scores decreased and sleep efficiency improved in both groups after treatment,with greater changes in the study group than in the control group(P＜0.05).Compared with pre-treatment,the blood flow velocities of the left middle cerebral artery,left anterior cerebral artery,and basilar artery increased in both groups after treatment,and those in the study group were significantly higher than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusions rTMS combined with Wuling Capsule has significant efficacy in the treatment of post-stroke depression complicated by insomnia.Its synergistic mechanism is related to the multi-level complementary effects of up-regulation of monoamine neurotransmitters,improvement of cerebral perfusion and remodeling of sleep structure,with a favorable safety profile.
王裕鹏;段智慧;王会林;刘瑞华;黄超
郑州大学附属洛阳中心医院神经内科,神经与肿瘤药物研发全国重点实验室,洛阳市神经系统疾病多组学研究与应用重点实验室,河南洛阳 471000郑州大学附属洛阳中心医院神经内科,神经与肿瘤药物研发全国重点实验室,洛阳市神经系统疾病多组学研究与应用重点实验室,河南洛阳 471000郑州大学附属洛阳中心医院神经内科,神经与肿瘤药物研发全国重点实验室,洛阳市神经系统疾病多组学研究与应用重点实验室,河南洛阳 471000郑州大学附属洛阳中心医院神经内科,神经与肿瘤药物研发全国重点实验室,洛阳市神经系统疾病多组学研究与应用重点实验室,河南洛阳 471000郑州大学附属洛阳中心医院神经内科,神经与肿瘤药物研发全国重点实验室,洛阳市神经系统疾病多组学研究与应用重点实验室,河南洛阳 471000
医药卫生
重复经颅磁刺激乌灵胶囊脑梗死后抑郁失眠
Repetitive transcranial magnetic stimulationWuling CapsulePost-stroke depressionInsomnia
《临床医学工程》 2026 (7)
769-773,5
河南省医学科技攻关计划联合共建项目(LHGJ20220946)
评论