TBS模式下高频重复经颅磁刺激联合齐拉西酮对精神分裂症患者认知功能的影响  

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation Combined with Ziprasidone on Cognitive Function in Schizophrenia Patients Under TBS Mode

作　　者：张辉 潘姝良 王召辉 ZHANG Hui;PAN Shuliang;WANG Zhaohui(Department of Psychiatry,Kaifeng Fifth People’s Hospital,Kaifeng 475000,China)

机构地区：[1]开封市第五人民医院精神科,河南开封475000

出　　处：《河南医学研究》2025年第7期1228-1232,共5页Henan Medical Research

摘　　要：目的本研究旨在比较Theta爆发式经颅磁刺激(TBS)模式下高频重复经颅磁刺激(rTMS)、齐拉西酮及两者联合疗法对精神分裂症患者认知功能影响的差异。方法选取2021年3月至2023年3月在开封市第五人民医院精神科就诊的精神分裂症患者110例,随机分为3组:rTMS组(37例)、齐拉西酮组(37例)以及联合疗法组(36例)。rTMS组接受TBS模式下的高频rTMS治疗,齐拉西酮组接受常规的齐拉西酮治疗,而联合疗法组则同时接受rTMS和齐拉西酮治疗。通过神经心理状态评定量表(RBANS)进行认知功能测试(包括即刻记忆、空间结构、言语功能、注意力和延迟记忆等)及阴性和阳性症状评分量表(PANSS)对疗效进行评估,采用简明精神病量表(BPRS)评测患者的病情。结果干预后,联合疗法组的即刻记忆、空间结构、注意力和延迟记忆评分均高于rTMS组和齐拉西酮组(P<0.05);联合疗法组的言语功能评分高于齐拉西酮组(P<0.05),与rTMS组间差异无统计学意义(P>0.05)。干预后,联合疗法组阴性症状评分、阳性症状评分、一般精神学症状评分和BPRS评分均低于rTMS组和齐拉西酮组(P<0.05)。结论TBS模式下高频rTMS联合齐拉西酮对精神分裂症患者的认知功能有改善效果,且在改善精神病症状方面也表现出优势。Objective The purpose of this study was to compare the effects of high-frequency repetitive transcranial magnetic stimulation(rTMS),ziprasidone and their combination therapy on cognitive function of schizophrenic patients under Theta burst stimulation(TBS)mode.Methods From March 2021 to March 2023,110 schizophrenic patients who visited the psychiatry department of the Kaifeng Fifth People’s Hospital were selected and randomly divided into three groups:rTMS group(37 cases),ziprasidone group(37 cases)and combination therapy group(36 cases).The rTMS group received high-frequency rTMS treatment under TBS mode,the ziprasidone group received conventional ziprasidone treatment,and the combination therapy group received both rTMS and ziprasidone treatment.Cognitive function tests(including immediate memory,spatial structure,speech function,attention,and delayed memory)were conducted using the neuropsychological state assessment scale(RBANS),as well as the positive and negative syndrome scale(PANSS)for both negative and positive symptoms.The efficacy was evaluated using the brief psychiatric scale(BPRS)to assess the patient’s condition.Results After intervention,the immediate memory,visuospatial construction,attention,and delayed memory scores of the combined therapy group were higher than those of the rTMS group and the clozapine group(P<0.05).The language function score of the combined therapy group was higher than that of the clozapine group(P<0.05),with no statistically significant difference compared to the rTMS group(P<0.05).After intervention,the combined therapy group showed lower scores in negative symptoms,positive symptoms,general psychiatric symptoms,and BPRS scores compared to the rTMS group and the clozapine group(P<0.05).Conclusion High frequency rTMS combined with ziprasidone in TBS mode can significantly improve the cognitive function of schizophrenic patients,and it also has advantages in improving the symptoms of psychosis.

关 键 词：精神分裂症 Theta爆发式经颅磁刺激模式 高频重复经颅磁刺激 齐拉西酮 认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]