| 边云,马泊涛,王智雄.重复经颅磁刺激改善失眠患者主观睡眠质量的Meta分析[J].四川精神卫生杂志,2019,32(3):216-222.,Meta-analysis of the effect of repetitive transcranial magnetic stimulation on subjective sleep quality in insomniac patients[J].SICHUAN MENTAL HEALTH,2019,32(3):216-222 |
| 重复经颅磁刺激改善失眠患者主观睡眠质量的Meta分析 |
| Meta-analysis of the effect of repetitive transcranial magnetic stimulation on subjective sleep quality in insomniac patients |
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| DOI：10.11886/j.issn.1007-3256.2019.03.005 |
| 中文关键词: 失眠症 经颅磁刺激 睡眠质量 Meta分析 |
| 英文关键词:Insomnia Transcranial magnetic stimulation Sleep quality Meta - analysis |
| 基金项目:北京市属医院科研培育计划(PX2018066) |
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| 【摘要】 目的 系统评价重复经颅磁刺激(rTMS)对失眠患者主观睡眠质量的疗效,为 rTMS治疗失眠提供循证依据?方法 系统检索PubMed?Embase?CochraneLibrary?万方数据库?维普中文期刊数据库?中国生物医学文献数据库和中国期刊全文数据库,纳入关于rTMS治疗失眠或睡眠障碍的随机对照研究?由两名研究者独立筛选文献?提取数据,并对纳入文献的方法学质量进行评价?采用RevMan5.2进行 Meta分析,采用 Stata13.0分析发表偏倚?结果 最终纳入13篇文献,共889例患者?Meta分析结果显示:rTMS治疗组睡眠质量改善的效果优于对照组(SMD=-1.11,95%CI:-1.46~-0.76,Z=6.22,P<0.01)?亚组分析结果显示,针对原发性和继发性失眠患者,rTMS治疗组睡眠质量改善的效果均优于对照组(原发性:SMD=-1.22,95%CI:-1.72~-0.72,Z=4.77,P<0.01;继发性:SMD=-1.04,95%CI:-1.55~-0.54,Z=4.04,P<0.01)?高频和低频 rTMS对患者睡眠质量评分的改善效果均优于对照组(高频:SMD=-0.44,95%CI:-0.76~-0.13,Z=2.73,P<0.01;低频:SMD=-1.24,95%CI:-1.61~-0.86,Z=6.45,P<0.01)?结论 高频或低频 rTMS联合常规治疗对失眠患者主观睡眠质量的改善效果更佳,对原发性和继发性失眠均有效? |
| 英文摘要: |
| Objective To systematically investigate the effect of repeated transcranial magnetic stimulation ( rTMS) on subjective sleep quality in patients with insomnia, so as to provide evidence - based basis for the treatment of insomnia by rTMS. Methods Randomized controlled trials ( RCTs ) about the treatment of insomnia by rTMS published in foreign and domestic databases, including PubMed, Embase, Cochrance Library, Wanfang, VIP, Chinese biomedical literature database and CNKI were retrieved. The following procedures including literature selection, data extraction and quality evaluation were performed independently by two researchers. Then the RevMan 5. 2 was used for meta - analysis and Stata 13. 0 was used for publication bias analysis.Results A total of 13 RCTs ( n = 889) were enrolled. Meta - analysis results showed that the sleep quality improvement effect of the rTMS group was better than that of the control group ( SMD = - 1 . 11 , 95% CI: - 1 . 46 ~ - 0. 76, Z = 6. 22, P < 0. 01 ) . Subgroup analysis showed that the sleep quality improvement effect for primary and secondary insomnia patients in rTMS group was better than that in control group ( primary: SMD = - 1 . 22, 95% CI: - 1 . 72 ~ - 0. 72, Z = 4. 77, P < 0. 01 ; secondary: SMD = - 1 . 04, 95%CI: - 1 . 55 ~ - 0. 54, Z = 4. 04, P < 0. 01 ) . The sleep quality improvement effect of high - frequency and low - frequency rTMS was better than that of control group ( high - frequency: SMD = - 0. 44, 95% CI: - 0. 76 ~ - 0. 13, Z = 2. 73, P < 0. 01 ; low -frequency: SMD = - 1 . 24, 95% CI: - 1 . 61 ~ - 0. 86, Z = 6. 45, P < 0. 01 ) . Conclusion High - frequency or low - frequency rTMS combined with conventional therapy can effectively ameliorate the subjective sleep quality of insomniacs, which is also effective for both primary and secondary insomnia. |
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