不同经颅磁刺激在急性期精神分裂症治疗中临床疗效及安全性观察  

Observational Study on the Clinical Efficacy and Safety of Different Transcranial Magnetic Stimulation Modalities in the Acute Phase Treatment of Schizophrenia

作　　者：覃荣刚 QIN Ronggang(Medical Affairs Department,Second People's Hospital of Baise,Baise 533000,China)

机构地区：[1]百色市第二人民医院医务科,广西百色533000

出　　处：《中国医学创新》2024年第18期50-54,共5页Medical Innovation of China

摘　　要：目的:评估不同经颅磁刺激(TMS)方案在急性期精神分裂症治疗中的临床效果及安全性。方法:采用随机数字表法将百色市第二人民医院2022年1月—2023年11月收治的122例急性期精神分裂症患者分为DL组和DM组,各61例。DL组接受背外侧前额叶皮层(dorsolateral prefrontal cortex,DLPFC)TMS治疗,DM组接受背内侧前额叶皮层(dorsomedial prefrontal cortex,DMPFC)TMS治疗。分别评估两组患者治疗前后临床疗效、修订版外显攻击行为量表(MOAS)、社会功能量表(PSP)及精神分裂症认知功能成套测验(MCCB)的得分变化,并记录不良反应。结果:治疗后,DM组临床总有效率略高于DL组,但差异无统计学意义(P>0.05)。治疗后,DL组阳性症状量表、阴性症状量表评分均低于DM组(P<0.05);两组一般精神病理学量表得分差异无统计学意义(P>0.05)。治疗后,DL组MOAS、PSP评分均低于DM组(P<0.05),两组MCCB评分差异无统计学意义(P>0.05)。两组患者治疗过程中无严重不良反应,且组间不良反应发生率差异无统计学意义(P>0.05)。结论:TMS治疗急性期精神分裂症安全、有效,其中DMPFC部位TMS治疗在改善社会功能和认知功能方面更具优势,DLPFC部位TMS治疗在改善外显攻击行为更具优势。Objective:To evaluate the clinical efficacy and safety of different transcranial magnetic stimulation(TMS)protocols in the treatment of acute schizophrenia.Method:Using a random number table method,122 patients with acute schizophrenia admitted to Second People's Hospital of Baise from January 2022 to November 2023 were divided into the DL group and the DM group,with 61 patients in each.The DL group received TMS treatment targeting at the dorsolateral prefrontal cortex(DLPFC),while the DM group underwent TMS therapy targeting at the dorsomedial prefrontal cortex(DMPFC).Clinical efficacy,scores on the modified overt aggression scale(MOAS),the personal and social performance scale(PSP)and the MATRICS consensus cognitive battery(MCCB)were assessed before and after treatment in both groups,adverse reactions were recorded.Result:After treatment,the clinical efficacy of the DM group was slightly higher than that of the DL group,but the difference was not statistically significant(P>0.05).After treatment,the positive and negative symptom scale scores in the DL group were lower than those in the DM group(P<0.05);there was no statistically significant difference in the score of general psychopathology scale(P>0.05).After treatment,the MOAS and PSP scores in the DL group were lower than those in the DM group(P<0.05),and there was no statistically significant difference in MCCB score between the two groups(P>0.05).No severe adverse reactions were observed during the treatment in either group,and there was no significant difference in the incidence of adverse reactions between groups(P>0.05).Conclusion:TMS is a safe and effective treatment for acute schizophrenia.TMS at the DMPFC site is more advantageous in improving social and cognitive functions,while TMS at the DLPFC site is more beneficial in reducing overt aggressive behavior.

关 键 词：经颅磁刺激 精神分裂症 安全性 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]