重复经颅磁刺激对门诊精神分裂症患者戒烟作用的对照研究  

A controlled trial of repetitive transcranial magnetic simulation for smoking cessation in outpatients with schizophrenia

作　　者：樊园媛 涂哲明[1] 张新风[1] 肖寒[1] 

机构地区：[1]湖北荆州市精神卫生中心,434000

出　　处：《临床精神医学杂志》2015年第4期241-243,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨重复经颅磁刺激(rTMS)对门诊精神分裂症患者戒烟的疗效及安全性。方法:55例门诊精神分裂症合并烟草依赖患者随机分为rTMS组(28例)和伪rTMS组(27例),分别接受右侧背外侧前额叶皮质rTMS刺激(10Hz,100%运动阈值)和伪刺激,疗程4周。入组时和治疗第1、2、4、8周末进行临床评估,以日均吸烟量、尼古丁依赖量表(FTND)评分、呼气末CO值及戒烟率评定疗效,以阳性及阴性症状量表(PANSS)、不良反应评定安全性。结果:日均吸烟量、FTND评分和呼气末CO值具有组别主效应(F=65.33,F=25.86,F=38.19)和时间主效应(F=24.66;F=29.92;F=18.92)(P<0.05或P<0.01);日均吸烟量具有交互作用(F=5.11,P<0.05);治疗第4周末rTMS组戒烟率(32.1%)高于伪rTMS组(7.4%,P<0.05);治疗前后两组PANSS评分及头痛发生率差异无统计学意义。结论:rTMS能减少精神分裂症患者的日均吸烟量和尼古丁依赖程度、提高戒烟率,安全性好。Objective： To explore the efficacy and safety of repetitive transcranial magnetic simulation（ r TMS） adopted to help outpatients with schizophrenia quit smoking. Method： Fifty-five schizophrenic outpatients with tobacco dependence were randomly divided into r TMS group（ n = 28） and sham r TMS group（ n =27）. The two groups received real or sham r TMS on the right dorsolateral prefrontal cortex（ 10 Hz and 100%motor threshold） respectivly for 4 weeks. The clinical assessments were conducted before treatment and at the end of 1,2,4,8 weeks after treatment. The curative effect was evaluated according to average daily smoking,score of nicotine dependence scale（ FTND）,content of carbon monoxide（ CO） at end of the breath and smoking cessation rate; while the safety assessments were by the positive and negative syndrome scale（ PANSS） and dverse reactions. Results： There were group main effect and time main effect on the average daily smoking,score of FTND and CO content at end of the breath（ F = 65. 33; F = 25. 86; F = 38. 19）（ F = 24. 66; F = 29. 92;F = 18. 92）（ P〈0. 05 or P〈0. 01）. There was group × time interaction on average daily smoking（ F = 5. 11,P〈0. 05）. The smoking cessation rate in the r TMS group（ 32. 1%） at the end of 4th week was significantly higher than the sham r TMS group（ 7. 4%）（ P〈0. 05）. The PANSS scores before and after treatment,the incidence of headache between the two groups had no statistical significance. Conclusion： r TMS can effectively reduce the average daily smoking and nicotine dependence in patients with schizophrenia and nicotine dependence; improve the smoking cessation rate. And it＇s a safer method.

关 键 词：重复经颅磁刺激 精神分裂症 戒烟 

分 类 号：R749.3[医药卫生—神经病学与精神病学]