θ短阵快速脉冲刺激治疗精神分裂症的meta分析  

Meta-analysis ofθshort array rapid pulse stimulation in treatment of schizophrenia

作　　者：李燕 闫蕾 李永杰 夏渊 梁振 唐海兰 郭佳琳 王柱 LI Yan;YAN Lei;LI Yong Jie;XIA Yuan;LIANG Zhen;TANG Hailan;GUO Jialin;WANG Zhu(School of Sports Medicine,Wuhan Institute of Physical Education,Wuhan430000,China;Department of Rehabilitation Medicine,Huangshi Central Hospital,Huangshi 435000,Hubei Province,China;Department of Rehabilitation Medicine,Guizhou Provincial Orthopedic Hospital,Guiyang 550002,China;Provincial Hospital of Hubei Province,Wuhan 430000,China)

机构地区：[1]武汉体育学院运动医学院,武汉430000 [2]黄石市中心医院康复医学科,湖北黄石435000 [3]贵州省骨科医院康复医学科,贵阳550002 [4]湖北省直属机关医院,武汉430000

出　　处：《中国心理卫生杂志》2024年第10期846-853,共8页Chinese Mental Health Journal

基　　金：2022年贵州省卫生健康委科学技术基金项目“针对原发性骨质疏松症的个性化运动处方设计与应用研究”(gzwkj2022-306)。

摘　　要：目的:采用meta分析评价θ短阵快速脉冲刺激(TBS)对精神分裂症的疗效及安全性。方法:检索中国知网、万方、维普、中国生物医学、Web of science、PubMed、Embase和Cochrane Library数据库自建库至2022年12月关于TBS治疗精神分裂症的随机对照试验(RCT),主要研究指标为阳性与阴性量表(PANSS),由2位评审员对纳入文献进行风险质量评估,并用RevMan5.3进行meta分析。结果:共纳入13个RCT,641例患者。Meta分析结果显示,干预时间≥2周、以左侧前额叶背外侧皮质为靶点的TBS更能降低PANSS总分(WMD=-4.63,95%CI:-5.75~-3.51,P<0.001)、阳性症状得分(WMD=-1.13,95%CI:-2.00~-0.26,P<0.05)、阴性症状得分(WMD=-2.51,95%CI:-2.77~-1.53,P<0.001)和一般精神病理症状得分(WMD=-1.20,95%CI:-1.80~-0.60,P<0.0001)。TBS不良反应有头晕等,无严重不良事件报告。结论:TBS安全性较好,2周及以上和左侧前额叶背外侧皮质靶点的刺激可能对精神分裂症患者的精神症状改善更明显。Objective:To evaluate the efficacy and safety of θ short burst rapid pulse stimulation(TBS) in treating schizophrenia by meta-analysis.Methods:Randomized controlled trials(RCTS) on TBS in the treatment of schizophrenia were searched from CNKI,Wanfang, VIP,China Biomedicine, Web of science, PubMed, Embase and Cochrane Library databases to December 2022.The main study indicator was the Positive and Negative Symptoms Scale(PANSS).Risk quality assessment of the included literatures was performed by two reviewers and statistical analysis was performed using RevMan5.3.Results:A total of 13 RCTS with 641 patients were included.Meta-analysis showed that TBS targeting the left dorsolateral prefrontal cortex(DLPFC) with intervention duration longer than 2 weeks decreased the PANSS total scores(WMD=-4.63,95%CI:-5.75--3.51,P<0.001),positive symptom scores(WMD=-1.13,95%CI:-2.00--0.26,P<0.05),negative symptom scores(WMD=-2.51,95%CI:-2.77--1.53,P<0.001) and general psychopathological symptom scores(WMD=-1.20,95%CI:-1.80--0.60,P<0.001).The adverse reactions of TBS included dizziness, and no serious adverse events were reported.Conclusion:TBS has high safety, and stimulation of left dorsolateral prefrontal cortex targets for more than 2 weeks could effectively improve psychiatric symptoms in patients with schizophrenia.

关 键 词：精神分裂症 θ短阵快速脉冲刺激 META分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.305.9[医药卫生—临床医学]