奥氮平联合经颅磁刺激治疗精神分裂症患者的疗效及不良反应  

The efficacy of olanzapine combined with transcranial magnetic stimulation in the treatment of schizophrenia patients

作　　者：杨阳 武建斌 张国梁 侯申坤 张欣[2] YANG Yang;WU Jianbin;ZHANG Guoliang(Mental Health Center of Zhangjiakou(Shalingzi Hospital of Zhangjiakou),Zhangjiakou 075000,China)

机构地区：[1]张家口市精神卫生中心/张家口市沙岭子医院,张家口075000 [2]河北省第六人民医院

出　　处：《国际精神病学杂志》2024年第2期405-409,共5页Journal Of International Psychiatry

基　　金：张家口市科技计划(编号1821100D);河北省医学科学研究计划项目(编号:ZD20140461)。

摘　　要：目的探讨奥氮平联合经颅磁刺激治疗精神分裂症患者的疗效及对患者肝肾功能的影响。方法选择张家口市沙岭子医院2018年3月~2019年3月收治依据《国际疾病分类(第10版)》诊断86例精神分裂症患者作为研究对象,按照随机数字表法将患者分为研究组(n=43)和对照组(n=43),研究组采用奥氮平联合经颅磁刺激治疗,对照组采用奥氮平治疗,两组均治疗8周,在治疗前与治疗结束后采用阳性与阴性症状量表评估患者症状、韦氏记忆量表评估患者认知功能、全自动分析仪测定肝肾功能,比较两组治疗疗效与不良反应发生率。结果治疗后研究组精神病理、阳性症状以及阴性症状评分低于对照组,差异比较存在统计学意义(t=3.635、6.836、9.363;P均<0.05);治疗后研究组指向记忆、无意义图形再认、图像自由回忆、人像特点回忆以及联想学习评分与记忆商评分高于对照组(t=3.735、8.458、4.770、4.125、4.849、7.232;P均<0.05);治疗后两组丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、肌酐、尿素氮等肝肾功能指标比较差异没有统计学差异(t=3.735、8.458、4.770、4.125、4.849、7.232;P均>0.05);研究组患者总有效率(76.74%)高于对照组(55.81%)(P<0.05);截止治疗结束两组不良反应发生率比较没有统计学差异(9.30%vs13.95%,χ^(2)=0.453,P>0.05)。结论精神分裂症患者采用奥氮平联合经颅磁刺激治疗有助于减轻患者精神病性症状,改善患者认知功能,且不会使患者肝肾功能损伤,疗效及安全性好。Objective To explored the efficacy of olanzapine combined with transcranial magnetic stimulation in the treatment of schizophrenia and the influence on liver and kidney function indexes of patients.Methods A total of 86 patients with schizophrenia diagnosed according to the International Classification of Diseases(10th Edition)were selected from Shalingzi Hospital of Zhangjiakou City from March 2018 to March 2019 as the study objects.According to the random number table method,patients were divided into the study group(n=43)and the control group(n=43).The study group received olanzapine combined with transcranial magnetic stimulation,and the control group received olanzapine.Both groups were treated for 8 weeks.Positive and Negative Symptom Scale was used to assess patients'symptoms,Wechsler Memory Scale was used to assess the cognitive function,and the automatic analyzer was used to detect liver and kidney function indexes before and after treatment.The therapeutic efficacy and incidence of adverse reactions were compared between the two groups.Results After treatment,the scores of psychopathology,positive symptoms and negative symptoms in the study group were lower than those in the control group,with statistically significant differences(t=3.635,6.836,9.363,all P<0.05).After treatment,the scores of directed memory,meaningless figure recognition,image free recall,portrait feature recall,associative learning and memory quotient in the study group were lower than those in the control group,with statistically significant differences(t=3.735,8.458,4.770,4.125,4.849,7.232,all P<0.05).After treatment,there were no statistically significant differences in liver and kidney function indexes such as alanine aminotransferase,aspartate aminotransferase,creatinine and urea nitrogen between the two groups(t=3.735,8.458,4.770,4.125,4.849,7.232,all P>0.05).The total effective rate by the end of treatment in the study group(76.74%)was higher than that in the control group(55.81%),with statistically significant differences(P<0.0

关 键 词：奥氮平 经颅磁刺激治疗 精神分裂症 疗效 肝肾功能 

分 类 号：R749.05[医药卫生—神经病学与精神病学]