摘要目的:探讨作用于左侧背外侧前额叶皮质区(DLPFC)的高频重复经颅磁刺激(H-F rTMS)联合吸烟相关线索诱发对香烟成瘾患者香烟渴求度(VAS评分)、呼出气CO浓度(CO ppm)和睡眠质量(PSQI评分)的影响。 方法:60例香烟成瘾患者随机分为A组(相关线索诱发rTMS组)、B组(非相关线索诱发rTMS组)和C组(rTMS组)，每组患者20例，在治疗过程中A、B组各有1例患者脱落。A组患者在H-F rTMS治疗的同时观看吸烟相关图片10 min，B组患者在H-F rTMS治疗的同时观看非吸烟相关图片10 min，C组患者仅给予H-F rTMS治疗。以上治疗均为每日1次，每周治疗5 d，连续治疗2周。3组患者均于治疗前和治疗2周后(治疗后)进行VAS评分、CO ppm和PSQI检测。 结果:治疗后，3组的香烟渴求度VAS评分、呼出CO浓度和PSQI评分较组内治疗前均显著下降，差异均有统计学意义( P<0.05)。A组治疗后的香烟渴求度VAS评分和呼出CO浓度分别为(24.74±15.77)分和(4.84±2.17)ppm，与B组和C组比较，差异均有统计学意义( P<0.05)。 结论:rTMS可显著改善香烟成瘾患者的香烟渴求、呼出气CO浓度和睡眠质量，其中H-F rTMS联合吸烟相关线索诱发的治疗效果最佳。

abstractsObjective:To explore the effect of repetitive high-frequency magnetic stimulation (H-F rTMS) of the dorsolateral part of the prefrontal cortex (DLPFC) combined with smoking-related cues on nicotine addicts′ cigarette craving, the concentration of exhaled CO and sleep quality.Methods:Sixty nicotine addicts were randomly divided into groups A, B and C, each of 20. All were given H-F rTMS five times a week for two weeks, while those in groups A and B watched smoking and non-smoking pictures for ten minutes, respectively. Before and after the intervention, all of the subjects self-reported their cigarette cravings using a visual analogue scale. Exhaled CO (CO ppm) was measured and the Pittsburgh sleep quality index (PSQI) was evaluated. Results:After the intervention the average craving score, CO ppm and PSQI score had improved significantly in all three groups. The average craving score and CO ppm of group A were both significantly better than in the other two groups. Conclusions:rTMS can significantly improve cigarette craving, CO ppm and sleep quality of cigarette adicts. Viewing smoking-related pictures as an addition to rTMS can even better the effects of rTMS.