不同重复经颅磁刺激模式对精神分裂症阴性症状患者的疗效研究  

A study on the efficacy of repetitive transcranial magnetic stimulation （rTMS） with differ- ent protocols in the treatment of the negative symptoms of schizophrenia

作　　者：孙喜蓉[1] 袁杰[1] 张洁[1] 黄瑛[1] 师典红[1] 严彩英[1] 沈亦明[1] 杨振东[1] 刘海君[1] 

机构地区：[1]上海市浦东新区精神卫生中心,上海200124

出　　处：《癫痫与神经电生理学杂志》2017年第4期210-212,共3页Journal of Epileptology and Electroneurophysiology(China)

基　　金：上海市卫计委科研基金（201440053）;上海市浦东新区卫生系统学科带头人基金（PWRd201304）

摘　　要：目的：探讨不同重复经颅磁刺激模式对精神分裂症阴性症状的疗效，为临床治疗提供一定依据。方法：抽取2015-2016年在上海市浦东新区精神卫生中心符合ICD-10精神分裂症的住院患者，以阴性症状为主，采取随机双盲，分为3组，分别为模式治疗A组（iTBS组）50例、模式治疗B组（10HzrTBS组）50例、对照组50例。入组后使用阳性症状和阴性症状评定量表（PANss）、阴性症状评定量表（SANS）、副反应量表（TESS）评定精神症状及副反应。结果：iTBS组、10HzrTMS组、对照组在治疗8周时PANSS减分率分别为0．23（±0．78）、0．21（±0．74）、0．13（±0．55），iTBS组、10HzrTMS组与对照组之间有显著差异（P〈0．01），前两组之间差异无统计学意义；SANS减分率分别为0．52（±0．80）、0．49（±0．85）、0．36（±0．40），治疗组与对照组之间有显著差异（P〈0．01），iTBS组、10HzrT—MS组两组之间差异无统计学意义。结论：经颅磁刺激作为一种无痛苦、无损伤、定位准确的物理治疗手段，对精神分裂症阴性症状的治疗有很好的效果，临床上可以作为一种辅助手段，以提高治疗效果，改善预后。Objective：To investigate the effect of repetitive Transcranial Magnetic Stimulation （ rT- MS） with different protocols in the treatment of negative symptoms of schizophrenia, and to provide evi dence for clinical treatment. Methods： Schizophrenia patients with negative symptoms were randomly di- vided into three groups,ITBS group, 10 Hz rTMS group and the control group ,50 patients each. The Positive and Negative Symptom Scale （PANSS）, the Scale for the Assessment of Negative Symptoms （SANS） and the Treatment Emergent Symptom Scale （TESS） were used to assess psychiatric symptoms and adverse reactions . Results： The reductions in the mean PANSS total scores in the treatment for 8 weeks in ITBS group, 10 Hz rTMS group and the control group were 0. 23±0. 78,0. 21±0. 74,0.13±0.55 respectively. There was no significant difference between iTBS group and 10 Hz rTMS group, but the difference is significant between them and the control group （P〈0. 01）; Reductions in the mean SANS total scores were 0. 52±0. 80.0. 49±0. 85.0. 36±0. 40 respectively. There was significant differ- ence between the treatment group and the control group （P〈0.01）, but no significant difference between the two treatment groups. Conclusion：As a painless, non-invasive, accurate positioning physical therapy, transcranial magnetic stimulation plays a very good therapeutic role in the treatment of negative symptoms of schizophrenia, which can improve the therapeutic effect and prognosis.

关 键 词：经颅磁刺激(rTMS) 精神分裂症 阴性症状 

分 类 号：R454.1[医药卫生—治疗学] R749.3[医药卫生—临床医学]