| 陈子,吴迪,李琴,程清,葛林阳,徐双兰,殷稚飞.高频重复经颅磁刺激对烟草依赖慢阻肺患者的影响[J].中国康复,2023,38(1):14-19 |
| 高频重复经颅磁刺激对烟草依赖慢阻肺患者的影响 |
| Effects of high-frequency rTMS on COPD patients with tobacco dependence |
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| DOI： |
| 中文关键词: 慢性阻塞性肺疾病 重复经颅磁刺激 烟草依赖 |
| 英文关键词: chronic obstructive pulmonary disease repetitive transcranial magnetic stimulation tobacco dependence |
| 基金项目:国家重点研发计划（2022YFF0710800）；国家自然科学基金（82000038）；广东省基础与应用基础研究基金自然科学基金面上项目（2022A1515010052）；广东省基础与应用基础研究基金区域联合基金青年基金项目（2021A1515111105）；南京市卫生科技发展专项基金（YKK20171） |
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| 中文摘要: |
| 目的：研究高频重复经颅磁刺激（rTMS）对烟草依赖慢阻肺（COPD）患者的影响。方法：将伴烟草依赖的稳定期中重度COPD患者60名，随机分为观察组和对照组组各30例。所有受试者均接受常规用药、生活方式干预及戒烟宣教，观察组在此基础上接受吸烟线索诱发下的高频rTMS（左背外侧前额叶皮层区）治疗5周；对照组仅在相同部位放置线圈电极但不施予刺激。检测治疗前后尿液可替宁（UC）浓度，采用香烟渴求度视觉模拟评分（VAS）、匹兹堡睡眠质量指数（PSQI）、6分钟步行试验（6MWT）和生命质量评价量表（SF-36）进行相关功能评定。结果：最终57例（观察组26例/对照组27例）患者完成研究。治疗５周后，2组的VAS、PSQI评分、UC浓度均较治疗前明显下降，且观察组明显低于对照组（均P<0.05）；6WMD较治疗前增加（P<0.05），SF-36评分的情感职能（RE）、精力（VT）、精神健康（MH）和一般健康（GH）评分均较治疗前增加，且观察组均优于对照组（均P<0.05）。结论：rTMS可以降低伴烟草依赖的稳定期中重度COPD患者的吸烟渴求度、香烟摄入量，提高其运动耐力和生活质量。 |
| 英文摘要: |
| Objective: To investigate the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on moderate to severe chronic obstructive pulmonary disease (COPD) patients in stable stage with tobacco dependence. Methods: A total of 60 COPD patients were randomly divided into control group (n=30) and treatment group (n=30). The control group was given routine medication, lifestyle intervention, smoking cessation education, and sham rTMS. On the basis of routine medication, lifestyle intervention and smoking cessation education, the treatment group received high-frequency rTMS on the left dorsolateral prefrontal cortex (DLPFC) combined with smoking cues. Smoking craving (VAS), urinary cotinine concentration (UC), Pittsburgh Sleep Quality Scale (PSQI), 6-min walking test (6MWT) and the Medical Outcome Study Short Form 36 (SF-36) were assessed before and after treatment of 5 weeks. Results: Finally, 57 patients (26/27) completed the whole intervention, and the results were included in statistical analysis. After treatment, VAS score, UC, PSQI score, and 6MWD in the treatment group were significantly improved as compared with those before treatment (P<0.05), and significantly better than those in the control group ［VAS (P<0.05), UC (P<0.05), PSQI (P<0.05)］. SF-36 scores of role-emotional (RE) (P<0.05), vitality (VT) (P<0.05), mental health (MH) (P<0.05) and general health (GH) (P<0.05) were significantly improved as compared with those before treatment, and significantly better than those in the control group ［RE (P<0.05), VT (P<0.05), MT (P<0.05), GH (P<0.05)］. Conclusion: High-frequency rTMS can improve smoking craving, cigarette consumption, exercise endurance and quality of life in patients on moderate to severe COPD patients in stable stage with tobacco dependence. |
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