重复经颅磁刺激治疗难治性精神分裂症的增效作用研究  

Augmentation of rTMS in the treatment of refractory schizophrenia

作　　者：孙丛丛 周丹娜 宁芳平 马良[3] 闫丽琼 任艳萍 马辛[1,2] Sun Congcong;Zhou Danna;Ning Fangping;Ma Liang;Yan Liqiong;Ren Yanping;Ma Xin(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China;The Third Hospital of Beijing Chaoyang District,Psychiatric department,Beijing 100121,China;Department of Psychosomatic Medicine,Dongfeng Community Health Service Center of Chaoyang District in Beijing,Beijing 100025,China)

机构地区：[1]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学人脑保护高精尖创新中心,北京100069 [3]北京市朝阳区第三医院精神科,北京100121 [4]北京市朝阳区东风社区卫生服务中心心身医学科,北京100025

出　　处：《首都医科大学学报》2018年第5期641-645,共5页Journal of Capital Medical University

基　　金：国家重点基础研究发展计划项目(2014CB744601);北京市科学技术委员会(首都临床特色应用研究)(Z131107002213095)~~

摘　　要：目的探索分析重复经颅磁刺激(repetitive transcranial magnetic stimulations,r TMS)治疗难治性精神分裂症增效作用的随机双盲对照研究。方法以2014年1月至2015年2月在首都医科大学附属北京安定医院及北京市朝阳区第三医院的住院及门诊精神分裂症患者为研究对象,共纳入53例患者,脱落3例,剩余50例根据阳性与阴性症状量表评分,分为低频(1Hz)治疗组26例和高频(10 Hz)治疗组24例,各治疗组再采用数字表法随机分为实验组和对照组。本研究为随机双盲对照研究,对照组进行伪刺激,评估两组精神分裂症患者的临床症状,将两组的治疗效果进行比较。结果共收集符合入组标准患者53例,共有50例完成研究。经t检验和χ2检验,两组间的基本资料差异均无统计学意义。低频治疗:组间差异均无统计学意义,但在时间上差异存在统计学意义,第4周末的量表评分明显降低。高频治疗:组间差异均无统计学意义,阴性因子分、精神病理分、一般精神病理分在时间上差异有统计学意义,第4周末的量表评分明显降低。治疗过程中有3例1Hz实验组患者和2例10 Hz实验组患者诉第1次治疗时感头痛、麻木感,余无不适主诉。结论尚未发现重复经颅磁刺激合并药物治疗对难治性精神分裂症患者的阳性症状及阴性症状有影响。Objective To explore the augmentation effect of repetitive transcranial magnetic stimulation in the treatment of refractory schizophrenia.Method Fifty schizophrenia patients were included and were divided into low frequency(1Hz)treatment group of 26 cases and high frequency(10 Hz)treatment group of 24 cases.Each treatment group was further randomly divided into an experimental group and a control group.This study is a randomized,double-blind,controlled study,the control group was subjected to pseudo-stimulation.The clinical symptoms of the two groups of patients were evaluated and the therapeutic effects of the two groups were compared.Results A total of 53 patients who met the inclusion criteria were enrolled,and a total of 50 patients completed the study.After t test andχ2 test,there was no significant difference in the basic data between the two groups.Low frequency treatment:there was no statistically significant difference between the groups.High frequency treatment:There was no statistically significant difference between the groups There was a time difference in the scale scores for the 4th weekend for all patients in the group.High frequency treatment:There was no statistically significant difference between the groups,Three patients with 1Hz experimental group and two patients with 10 Hz experimental group complained of headache and numbness during the first treatment,other patients are not uncomfortable.Conclusion Repetitive transcranial magnetic stimulation combined with drug therapy has not been found to have an effect on positive and negative symptoms in patients with refractory schizophrenia.

关 键 词：重复经颅磁刺激 精神分裂症 增效作用 

分 类 号：R749.3[医药卫生—神经病学与精神病学]