【摘要】 目的探讨重复经颅磁刺激(r TMS)治疗首发精神分裂症患者的临床疗效。方法研究纳入124例首发精神分裂患者,随机分为研究组与对照组。两组均给予口服奥氮平,研究组在药物治疗基础上,合并r TMS治疗,采用的频率为10 Hz,刺激强度为90%运动阈值;对照组则给予伪r TMS治疗。连续治疗4周后,利用PANSS、BRANS以及TESS评分表分别评估精神分裂症患者的精神症状、认知功能以及不良反应。两组间率的比较采用卡方检验;同组内干预前、后的比较采用配对样本的符号(Sign)检验,组间变化率的检验采用Wilcoxon符号平均秩和检验。结果经过4周治疗后,研究组与对照组的PANSS评分均显著降低(P<0.05);两组PANSS评分的减分率(研究组vs.对照组:44.1%vs.35.2%,P<0.05)以及阴性症状评分的减分率(27.6%vs.11.5%,P<0.05)差异均具有统计学意义。研究组的整体有效率均高于对照组(85.0%vs.72.1%,P<0.05)。治疗后,研究组的RBANS总分、即刻记忆、视觉广度、注意力、延时记忆等较治疗前均显著升高(P<0.05),对照组仅有注意力评分出现显著变化(P<0.05)。两组的TESS评分与不良反应发生率均没有显著性差异(P>0.05)。结论 r TMS治疗能够显著改善精神分裂症患者的阴性症状与认知功能,为精神分裂症的治疗提供新的途径。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of repetitive transcranial magnetic stimulation(r TMS) on first-episod schizophrenia patients. Methods A total of 124 first-episod schizophrenia patients were recruited into the research, and were randomly divided into research group and control group. Both groups were orally treated with olanzapine. Based on the drug treatment, research group were also treated with 10 Hz of r TMS at 90% of motor threshold over the left dorsolateral prefrontal cortex; while control group were received sham r TMS treatment. After 4-week treatment, PANSS, BRANS, and TESS were applied to assess the psychotic symptoms, cognitive function and adverse reaction for both groups, respectively. The ratio level data between the two groups were compared by chi square test. The comparison of data between pre- and post-treatment was conducted by matched-pairs signed-ranks test, and the data between each groups were compared by Wilcoxon’s Sign Rank Test. Results After 4-week treatment, PANSS of the research group and control group were both significantly decreased(P<0.05), however, significant difference in reductive ratio of PANSS(study group vs. control group: 44.1% vs.35.2%, P<0.05) and negative symptom score(27.6% vs. 11.5%,P<0.05) were observed. The overall effective rate of the study group was higher than that of the control group(85% vs. 72.1%, P<0.05). Compared with the baseline, the total score of RBANS, factor scores of immediate memory, visuospatial-constructional, attention, delayed memory increased significantly in research group(P<0.05), however, only the factor score of attention were significantly improved(P<0.05). There was no significant difference in TESS and side effects between research group and control group(P>0.05). Conclusion The treatment of r TMS alleviated negative symptoms and improved cognitive function of schizophrenia patients significantly, suggesting that r TMS might provide a new way for the therapy of schizophrenia.更多还原