改良电抽搐治疗难治性精神分裂症的作用  

Modified electroconvulsive therapy in the treatment of refractory schizophrenia

作　　者：汪正华[1] 凌云熹[1] 夏仲[1] 

机构地区：[1]安徽省芜湖市第四人民医院,241000

出　　处：《临床精神医学杂志》2011年第4期252-254,共3页Journal of Clinical Psychiatry

摘　　要：目的:评估氯氮平合并改良电抽搐(MECT)治疗对难治性精神分裂症的临床疗效及安全性。方法:74例难治性精神分裂症患者随机分为两组,联合治疗组37例,在应用氯氮平的基础上联合MECT治疗;单药治疗组37例,仅给予氯氮平治疗;观察12周。分别于治疗前及治疗后4周、8周、12周末采用阳性和阴性症状量表(PANSS),治疗中出现的症状量表(TESS)评定其临床疗效和不良反应;治疗前及治疗结束后ld、1周、2周采用韦氏记忆量表(WMS)评定MECT对记忆的影响。结果:治疗12周后,联合治疗组的PANSS减分率(46.17±16.14)%,临床总有效率为58.7%;单药治疗组的PANSS减分率(32.26±14.27)%,临床总有效率为28.9%,两组差异有显著性(P<0.05或P<0.01)。两组TESS评分差异无显著性(P>0.05)。WMS评分在治疗结束后1d明显降低(P<0.01),但在治疗1周、2周与治疗前差异无显著性(P>0.05)。结论:改良电抽搐治疗联合氯氮平对难治性精神分裂症有效、安全。Objective：To explore efficacy and safety of clozapine combined with MECT（modified electroconvulsive therapy） in the treatment of refractory schizophrenia.Method：74 patients with refractory schizophrenia（TRS） were randomly assigned to receive clozapine combined with MECT（n=37） or clozapine treatment（n=37） for 12 weeks.Positive and negative syndromes scale（PANSS） and treatment emergent symptoms scale（TESS） were used to evaluate efficacy and side effect before treatment and at the ends of the 4th、8th and 12th week treatment.The Wechsler Memory Scale（WMS） was used to evaluate the memory level of the combination group before and one day,one week and two weeks after the treatment.Results：After 12 week treatment,The decreased rates of PANSS score was（46.17±16.14）% in combination group and（32.26±14.27）% in single group;The response rate 58.7%in combination group was significantly higher than 21.9%in single group.The two groups showed significant difference in decreased score and response rate（P0.05 or P0.01）,and no significant difference in TESS score.There was no significant difference in WMS score between before and after treatment（P0.05）.Conclusion：Clozapine combined with MECT is effective and safe in the treatment of refractory schizophrenia.

关 键 词：难治性精神分裂症 改良电抽搐治疗 氯氮平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]