重复经颅磁刺激对关键期精神分裂症患者阴性症状疗效及安全性研究  

Effect of repetitive transcranial magnetic stimulation on the efficacy and safety of negative symptoms of critical period schizophrenia

作　　者：封阳[1] 徐静文[1] 管晓波[1] 于士静 Feng Yang;Xu Jingwen;Guan Xiaobo;Yu Shijing(Rehabilitation Ward,Shanghai Third Civil Mental Center,Shanghai 200435)

机构地区：[1]上海市民政第三精神卫生中心康复病区,200435

出　　处：《山西医药杂志》2022年第15期1687-1691,共5页Shanxi Medical Journal

基　　金：上海市民政局2018年局级课题(3-2-55)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)改善关键期精神分裂症患者阴性症状的疗效及安全性。方法入组60例关键期精神分裂症患者,给予利培酮药物维持治疗,后随机分为rTMS组,伪刺激组,分别于治疗前、治疗4周末、治疗8周末对研究对象行阳性与阴性症状量表(PANSS)、阴性症状量表(SANS)测试,比较2组间及各变量治疗前后的差异。结果①治疗4周后,rTMS组PANSS量表阴性症状分及总分与治疗前比较差异有统计学意义(P<0.01),与伪刺激组比较差异也有统计学意义(P<0.01)。治疗4周后,rTMS组SANS量表情感平淡、思维贫乏、意志缺乏、兴趣减退、注意障碍及总分6项与治疗前比较差异有统计学意义(P<0.01),与伪刺激组比较差异也有统计学意义(P<0.01)。②治疗8周后随访PANSS量表阴性症状分及总分、SANS量表各项分数均有所改善,提示rTMS治疗对阴性症状的疗效具有可持续性。③治疗前后2组间均出现不同程度的不良反应,但差异无统计学意义(P>0.05)。结论rTMS治疗对关键期精神分裂症患者阴性症状具有改善作用,且疗效有持续效应,安全性好。Objective To investigate the efficacy and safety of repetitive transcranial magnetic stimulation(rTMS)in improving the negative symptoms of patients with critical period schizophrenia.Methods Sixty schizophrenic patients in the critical period were randomly divided into rTMS group and sham stimulation group.Positive and negative syndrome scale(PANSS)and negative symptom scale(SANS)were tested before treatment,4 weeks after treatment and 8 weeks after treatment.Blood routine,biochemical routine,electrocardiograph(ECG)and electroencephalo-graph(EEG)were measured before treatment,4 weeks after treatment and 8 weeks after treatment.The difference before and after treatment were measured.Results After 4 weeks of treatment,the PANSS negative symptom score and total score of rTMS group were significantly higher than those before treatment(P<0.01),and were significantly higher than those of sham stimulation group(P<0.01).After 4 weeks of treatment,the scores of SANS in rTMS group were significantly lower than those before treatment(P<0.01)and those in sham stimulation group(P<0.01).After 8 weeks of treatment,PANSS negative symptom score and total score,SANS scores were improved.There were different degrees of adverse reactions in the two groups before and after treatment,but there was no significant difference between the two groups(P>0.05).Conclusion rTMS treatment can improve the negative symptoms of patients with critical period schizophrenia,and the curative effect has a sustained effect with good safety.

关 键 词：经颅磁刺激 精神分裂症 阴性症状 

分 类 号：R749.3[医药卫生—神经病学与精神病学]