利培酮联合低频重复经颅磁刺激治疗精神分裂症顽固性幻听的效果及对事件相关电位的影响  

Effect of risperidone combined with low-frequency repetitive transcranial magnetic stimulation in the treatment of intractable auditory hallucinations in schizophrenia and its influence on event-related potentials

作　　者：杨菊 罗兴刚 李清均[2] YANG Ju;LUO Xing-gang;LI Qing-jun(Department of Mental Ward of Psychiatry,Chongqing Mental Health Center,Chongqing 404100,China;Department of Early Intervention,Chongqing Mental Health Center,Chongqing 404100, China)

机构地区：[1]重庆市精神卫生中心精神科男病区,重庆404100 [2]重庆市精神卫生中心早期干预科,重庆404100

出　　处：《实用医院临床杂志》2022年第4期169-173,共5页Practical Journal of Clinical Medicine

摘　　要：目的探究利培酮联合低频重复经颅磁刺激(rTMS)治疗精神分裂症顽固性幻听的效果及对事件相关电位(P300)的影响。方法采用随机双盲对照设计,将138例精神分裂症顽固性幻听患者分为研究组和对照组各69例,对照组行利培酮联合低频rTMS伪刺激治疗,研究组行利培酮联合低频rTMS真刺激治疗。比较两组治疗前后幻听评定量表(AHRS)、阳性与阴性量表(PANSS)评分及P300检查指标,评估整体疗效、生活质量和安全性。结果两组总有效率比较差异有统计学意义(P<0.05);治疗6周后,两组PANSS评分、AHRS评分均较治疗前下降,且研究组低于对照组(P<0.05);两组生活质量评分均较治疗前上升,且研究组高于对照组(P<0.05);研究组两点处P3潜伏期低于对照组,P3波幅高于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论较单药利培酮,联合低频rTMS干预精神分裂症顽固性幻听疗效更确切,在改善幻听症状、认知功能及生活质量上优势更显著。Objective To investigate the effect of risperidone combined with low-frequency repetitive transcranial magnetic stimulation(rTMS)in the treatment of intractable auditory hallucinations in schizophrenia,and its influence on event-related potentials(P300).Methods A randomized double-blind controlled study was conducted among 138 patients with schizophrenia and intractable auditory hallucinations.The patients were randomized into a study group(n=69,risperidone combined with true low-frequency rTMS)and a control group(n=69,risperidone combined with false low-frequency rTMS).The scores of Auditory Hallucination Rating Scale(AHRS)and Positive and Negative Syndrome Scale(PANSS),and P300 examination indexes were compared between the two groups before and after treatment.The overall curative effect,quality of life and safety were evaluated.Results There was a statistically significant difference between the two groups in total effective rate(P<0.05).After 6 weeks of treatment,the PANSS score and AHRS score of the two groups were significantly decreased,and the study group had lower scores than the control group(P<0.05).The quality of life score of the two groups were significantly increased,and the study group had higher scores than the control group(P<0.05).The P3 latent periods at two points in the study group were significantly shorter than those in the control group(P<0.05),and the P3 amplitude was significantly greater than that in the control group(P<0.05).There was no statistically significant difference in adverse reactions(P>0.05).Conclusion Compared with risperidone,risperidone combined with low-frequency rTMS is more effective in the treatment of intractable auditory hallucinations in schizophrenia.The combined treatment has more advantages in alleviating auditory hallucinations,and improving cognitive function and quality of life.

关 键 词：利培酮 低频重复经颅磁刺激 精神分裂症 顽固性幻听 

分 类 号：R743.33[医药卫生—神经病学与精神病学]