MECT联合利培酮对难治性精神分裂症的增效作用  

Study on Synergetic Action of MECT Combined With Risperidone in the Treatment-resistant Schizophrenia

作　　者：钱兴山 闻传毅 刘长城[3] 涂清芬 张新风 QIAN Xingshan;WEN Chuanyi;LIU Changcheng;TU Qingfen;ZHANG Xinfeng(Tenth Wards,The Mental Health Center of Jingzhou,Jingzhou Hubei 434000,China;Third Wards,The Mental Health Center of Jingzhou,Jingzhou Hubei 434000,China;Ninth Wards,The Mental Health Center of Jingzhou,Jingzhou Hubei 434000,China;Department of Neurology Intensive Care Unit,The First People′s Hospital of Jingzhou,Jingzhou Hubei 434000,China;The Mental Health Institute of Yangtze University,Jingzhou Hubei 434000,China)

机构地区：[1]湖北省荆州市精神卫生中心十病区,湖北荆州434000 [2]湖北省荆州市精神卫生中心三病区,湖北荆州434000 [3]湖北省荆州市精神卫生中心九病区,湖北荆州434000 [4]湖北省荆州市第一人民医院神经科重症监护室,湖北荆州434000 [5]长江大学精神卫生研究所,湖北荆州434000

出　　处：《中国继续医学教育》2019年第34期129-132,共4页China Continuing Medical Education

摘　　要：目的探讨无抽搐电休克治疗(MECT)对难治性精神分裂症(TRS)患者阴性症状、认知及社会功能的影响。方法选择2017年1月-2018年12月在荆州市精神卫生中心门诊就诊的TRS患者90例,将其随机分为对照组和观察组,每组各45例。对照组采用利培酮药物治疗,观察组在此基础上应用MECT治疗,两组疗程均为4周。分别于治疗前(入院次日)及治疗后(治疗第4周末)采用阴性症状量表(SANS)、威斯康辛卡片分类测验(WCST)、世界卫生组织残疾评定量表Ⅱ(WHO-DASⅡ)评估2组患者的阴性症状、认知功能和社会功能,并对上述指标的改善情况进行对比分析。结果 2组患者治疗后SANS总分及各分量表评分、WCST各项评分、WHO-DAS-Ⅱ各项评分及总分均较治疗前明显改善,对照组和观察组治疗前后组内比较差异均有统计学意义(P <0.05);且观察组上述指标改善程度均明显优于对照组,治疗后组间比较差异均有统计学意义(P <0.05)。结论TRS患者在药物治疗的基础上联合MECT治疗,可有效改善患者的阴性症状,提高患者的认知功能和社会功能,可以在临床上广泛应用和推广。Objective To investigate the effect of Modified Electroconvulsive Therapy(MECT) on negative symptoms, cognition and social function in patients with Treatment-resistant Schizophrenia(TRS). Methods Ninety patients with TRS who were admitted to the outpatient clinic of Jingzhou Mental Health Center from January 2017 to December 2018 were randomly divided into control group and observation group, with 45 cases in each group. The control group was treated with risperidone, and the observation group was treated with MECT. The course of treatment was 4 weeks. The Scale for Assessment of Negative Symptoms(SANS), the Wisconsin card sorting test(WCST), and the WHO Disability Assessment Schedule-Ⅱ(WHO-DAS-Ⅱ) were evaluated before treatment(the day after admission) and after treatment(the fourth weekend of treatment). The patients had negative symptoms, cognitive function and social function, and compared the improvement of the above indicators. Results After treatment, the total scores of SANS and the scores of each subscale, WCST scores, WHO-DAS-Ⅱ scores and total scores of the two groups were significantly improved compared with those before treatment. The differences between the control group and the observation group before and after treatment were compared. All the statistical significance(P < 0.05);and the improvement of the above indicators in the observation group were significantly better than the control group, the difference between the groups after treatment was statistically significant(P < 0.05). Conclusion Patients with TRS combined with MECT on the basis of drug therapy can effectively improve the negative symptoms of patients and improve their cognitive function and social function. They can be widely applied and promoted in clinical practice.

关 键 词：无抽搐电休克 利培酮 难治性精神分裂症 阴性症状 认知功能 社会功能 

分 类 号：R453[医药卫生—治疗学]