Clinical efficacy of repetitive transcranial magnetic stimulation combined with dexzopiclone in the treatment of type 2 diabetic patients with chronic insomnia
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摘要: 目的 观察重复经颅磁刺激(rTMS)联合右佐匹克隆治疗2型糖尿病慢性失眠者的血清学指标变化及临床疗效。 方法 选取2型糖尿病合并慢性失眠患者95例为研究对象,随机分为对照组(n=48)和研究组(n=47)。对照组在基础治疗基础上给予右佐匹克隆药物治疗,研究组在对照组基础上给予rTMS。比较2组治疗前后空腹血糖(FBG)、白细胞介素(IL-6)、肿瘤坏死因子(TNF-α)水平及匹兹堡睡眠质量指数(PSQI)评分。 结果 2组治疗后FBG、血浆IL-6、TNF-α较治疗前降低,且研究组降低程度更显著,差异有统计学意义(P<0.05)。治疗后,研究组PSQI各项得分较对照组下降更明显(P<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。 结论 rTMS联合右佐匹克隆治疗糖尿病慢性失眠可明显降低患者FBG、IL-6、TNF-α水平及PSQI评分,改善睡眠质量。Abstract: Objective To observe the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with dexzopiclone in treatment of type 2 diabetic patients with chronic insomnia. Methods Ninety-five type 2 diabetes patients with chronic insomnia were selected and randomly divided into control group and study group. The control group(n=48)was treated with dexzopiclone on the basis of conventional treatment, while the study group(n=47)was additionally treated with rTMS on the basis of the control group. The levels of fasting blood glucose(FBG), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and the Pittsburgh Sleep Quality Index(PSQI)score before and after treatment between the two groups were compared. Results The levels of FBG, IL-6 and TNF-α were significantly decreased in the two groups after treatment(P<0.05), and were significantly lower in the study group than those in the control group(P<0.05). After treatment, PSQI score of each item was significantly lower in the study group than that of the control group(P<0.05). The total effective rate of the study group was significantly higher than that of the control group(P<0.05). Conclusion rTMS combined with dexzopiclone can significantly reduce the levels of FBG, IL-6, TNF-α and PSQI score, and improve the sleep quality of patients.
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CESPEDES E M, DUDLEY K A, SOTRES-ALVAREZ D, et al. Joint associations of insomnia and sleep duration with prevalent diabetes: The Hispanic Community Health Study/Study of Latinos(HCHS/SOL)[J]. J Diabetes, 2016, 8(3): 387-397.
ZHU B Q, XIE M, PARK C G, et al. Adaptation of the Pittsburgh Sleep Quality Index in Chinese adults with type 2 diabetes[J]. J Chin Med Assoc, 2018, 81(3): 242-247.
SAKAMOTO K, HIGO-YAMAMOTO S, EGI Y, et al. Memory dysfunction and anxiety-like behavior in a mouse model of chronic sleep disorders[J]. Biochem Biophys Res Commun, 2020, 529(2): 175-179.
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2013年版)[J]. 中国糖尿病杂志, 2014, 22(8): 10002-10042. 中华医学会神经病学分会, 中华医学会神经病学分会睡眠障碍学组. 中国成人失眠诊断与治疗指南(2017版)[J]. 中华神经科杂志, 2018, 51(5): 324-335 唐向东, 李桃美, 张继辉. 失眠症的临床评估与治疗[J]. 中华精神科杂志, 2017, 50(1): 3-4. LEE S W H, NG K Y, CHIN W K. The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: a systematic review and meta-analysis[J]. Sleep Med Rev, 2017, 31: 91-101.
VARGAS I, LOPEZ-DURAN N. Investigating the effect of acute sleep deprivation on hypothalamic-pituitary-adrenal-axis response to a psychosocial stressor[J]. Psychoneuroendocrinology, 2017, 79: 1-8.
VARGAS I, VGONTZAS A N, ABELSON J L, et al. Altered ultradian cortisol rhythmicity as a potential neurobiologic substrate for chronic insomnia[J]. Sleep Med Rev, 2018, 41: 234-243.
李莹雪, 陈贵海. 慢性失眠患者血液生物学标志物的研究进展[J]. 中国神经免疫学和神经病学杂志2018, 25(06): 399-402 。
DEVINE J K, BERTISCH S M, YANG H, et al. Glucocorticoid and inflammatory reactivity to a repeated physiological stressor in insomnia disorder[J]. Neurobiol Sleep Circadian Rhythm, 2019, 6: 77-84.
WIESER V, MOSCHEN A R, TILG H. Inflammation, cytokines and insulin resistance: a clinical perspective[J]. Arch Immunol Ther Exp(Warsz), 2013, 61(2): 119-125.
WANG X, BAO W, LIU J, et al. Inflammatory Markers and Risk of Type 2 Diabetes: a systematic review and meta-analysis[J]. Diabetes Care, 2013, 36(1): 166-175.
DIXON C L, HARRISON N L, LYNCH J W, et al. Zolpidem and eszopiclone prime α1β2γ2 GABAAreceptors for longer duration of activity[J]. Br J Pharmacol, 2015, 172(14): 3522-3536.
张清如, 王巍, 郑小星. 文拉法辛联合右佐匹克隆治疗广泛性焦障虑碍伴失眠症状效果研究[J]. 中外医学研究, 2020, 18(2): 1-3. LIANG L, HUANG Y, XU R, et al. Eszopiclone for the treatment of primary insomnia: a systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials[J]. Sleep Med, 2019, 62: 6-13.
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