【摘要】 目的探讨利培酮联合低频重复经颅磁刺激治疗精神分裂症患者的疗效及对血清多巴胺(DA)浓度的影响。方法选取2018年11月～2019年8月广州市民政局精神病院收治的154例精神分裂症患者作为研究对象,按照随机数字表法将其分为研究组和对照组,每组各77例。研究组采用利培酮合并低频重复经颅磁刺激治疗,对照组采用利培酮合并假性经颅磁刺激治疗,比较两组临床疗效总体评估情况、治疗前后阳性和阴性症状量表(PANSS)、临床疗效总体评估量表(CGI)、不良反应量表(TESS)评分及外周血中DA浓度变化情况。结果治疗后,研究组的临床疗效总体评估高于对照组,差异有统计学意义(P<0.05)。研究组治疗后的PANSS总分、PANSS各因子分、CGI评分均低于治疗前,差异有统计学意义(P<0.05)。对照组治疗后PANSS总分、PANSS各因子分、CGI评分与治疗前比较,差异无统计学意义(P>0.05)。治疗后,研究组的PANSS总分、PANSS各因子分、CGI评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的TESS评分、外周血DA神经递质浓度比较,差异无统计学意义(P>0.05)。结论利培酮联合使用低频重复经颅磁刺激治疗精神分裂症患者,对改善患者的临床症状有一定的效果,对外周血清DA浓度无明显影响,无明显不良反应,有积极的临床应用价值,值得临床推广。更多还原

【Abstract】 Objective To explore the effects of Risperidone combined with repetitive transcranial magnetic stimulation(rTMS)on patients and serum dopamine(DA) in the treatment with schizophrenia. Methods A total of 154 patients with schizophrenia admitted to the Psychiatric Hospital of Guangzhou Civil Administration Bureau from November 2018 to August 2019 were selected as the research subjects. According to random number table method, they were divided into the research group and the control group, with 77 cases in each group. The research group was treated with Risperidone combined with low-frequency repetitive transcranial magnetic stimulation, while the control group was treated with Risperidone combined with pseudo transcranial magnetic stimulation. The overall evaluation of clinical efficacy, the positive and negative symptoms scale(PANSS), clinical global impression(CGI) and treatment emergent symptom scale(TESS), and the changes of DA concentration in peripheral blood before and after treatment were compared between the two groups. Results After treatment, the overall evaluation of clinical efficacy in the research group was higher than that in the control group, and the difference was statistically significant(P<0.05). The total score of PANSS after treatment in the research group was lower than that before treatment, and the difference was statistically significant(P<0.05). After treatment, the total score of PANSS of the research group was lower than that of the control group, and the difference was statistically significant(P<0.05). After treatment, there were no significant differences in TESS score and DA neurotransmitter concentration in peripheral blood between the two groups(P>0.05). Conclusion Risperidone combined with low-frequency repetitive transcranial magnetic stimulation in the treatment of schizophrenia patients has certain effect on improving the clinical symptoms of patients, and there is no significant influence on the peripheral serum DA concentration and no obvious adverse reactions. It has positive clinical application value and is worthy of clinical promotion.更多还原