利培酮联合改良电休克或重复经颅磁刺激治疗精神分裂症的疗效观察  

Effects of risperidone combined with modified electric convulsive therapy or repetitive transcranial magnetic stimulation on treatment of schizophrenia

作　　者：乔昱婷[1] 薛芬[1] 彭正午[1] 张瑞国[1] 谭庆荣[1] 

机构地区：[1]第四军医大学西京医院心身科,710032

出　　处：《神经疾病与精神卫生》2014年第5期457-459,共3页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金（81171285,81401109）,陕西省自然科学基金（2013JQ4014）

摘　　要：目的 探讨在非典型抗精神病药物利培酮作用基础上联合改良电休克治疗（MECT）或重复经颅磁刺激（rTMS）治疗精神分裂症的疗效及不良反应.方法 将72例精神分裂症患者采用随机数字表法分为MECT组与rTMS组,各36例,分别给予利培酮（起始剂量3 ml/d,最大剂量6 ml/d）联合MECT或rTMS,在治疗1、2、4及8周末,采用阳性与阴性症状量表（PANSS）评定临床疗效,并且在2周末采用不良反应症状量表（TESS）评估不良反应.结果 经过8周治疗后,MECT组与rTMS组的有效率之间（72.22％比63.88％）差异无统计学意义（x2=2.017,P＞0.05）.两组在治疗前和治疗各阶段PANSS总分及各因子分差异均无统计学意义,在治疗8周末与组内治疗前比较,各项评分均显著下降,差异有统计学意义（P＜0.01）.治疗2周末时评估,MECT组发生不良反应例数（25例）明显高于rTMS组（18例）,两组比较差异有统计学意义（x2=5.808,P＜0.05）.结论 利培酮联合MECT或rTMS对精神分裂症状的疗效相当,而rTMS治疗的不良反应更少.Objective To investigate the efficacy and safety of risperidone combined with repetitive transcranial magnetic stimulation（rTMS） or modified electric convulsive therapy（MECT） on the treatment of schizophrenia. Methods Totals of 72 patients with schizophrenia were randomly treated with risperidone plus MECT （MECT group） or risperidone plus rTMS （rTMS group） for 8 weeks （ n = 36 for each group）. The initial dose of risperidone was 3 ml/d and the maximal dose was 6 ml/d. The Positive and Negative Syndrome Scale （PANSS） was used to evaluate the efficacy at weekend of 1, 2, 4 and 8, and Treatment Emergent Symptom Scale （TESS） was used to evaluate the adverse reactions at the 2nd week. Results Effective rate in MECT and rTMS was 72.22% and 63.88% respectively, and the difference was statistically significant （x^2 = 2. 017 ,P 〉 0.05）. Both the total score of PANSS in both group were decreased significantly with the extension of treatment time, but there were no significant differences between these two groups in each weekend. Compared with that before treatment, the scores were decreased greatly in both groups after treatment （P 〈 0.01）. Adverse reactions in treatment 2 weekends occuring in MECT group （25 cases） were significantly higher than those in rTMS group （18 cases）, the difference was statistically significant （x^2= 5. 808,P 〈 0.05）. Conclusions The efficacy of risperidone combined with rTMS is the same as risperidone combined with MECT, and rTMS show less adverse reactions than that of MECT group.

关 键 词：精神分裂症 改良电休克治疗 重复经颅磁刺激 利培酮 疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]