摘要
目的探讨20 Hz重复经颅磁刺激(rTMS)联合奥氮平治疗精神分裂症患者精神症状、认知功能的疗效及安全性。方法选取联勤保障部队第九八八医院精神科住院患者75例,按随机数字表分为研究组38例和对照组37例。研究组采用20 Hz rTMS刺激左侧前额叶背外侧皮质(DLPFC),联合奥氮平治疗,对照组单独应用奥氮平治疗。于治疗前和治疗4周末采用阳性和阴性症状量表(PANSS)评估两组精神症状,应用探究性眼动检查(EEM)评估注意力、记忆力等认知功能,应用治疗中出现的副反应量表(TESS)评估安全性。结果两组患者治疗4周后,PANSS量表总分、阳性症状分、阴性症状分及一般症状分均低于治疗前,差异有统计学意义(P<0.05)。治疗4周末,研究组总分(47.68±4.17)分、阴性症状分(12.24±1.98)分及一般症状分(20.18±3.48)分均低于对照组(53.42±4.66)分、(14.35±2.21)分、(23.47±3.89)分,差异有统计学意义(P<0.05)。两组治疗4周末,探究性眼动的凝视点数(the number of eye fixations,NEF)分升高、反应性探索评分(responsive search score,RSS)分升高、分析值(D值)下降,与治疗前比较,差异有统计学意义(P<0.05)。研究组NEF(31.82±4.42)分、RSS(10.56±2.37)分高于对照组(28.42±3.98)分、(8.25±2.19)分,D值(-0.89±1.56)低于对照组(1.08±1.28),差异均有统计学意义(P<0.05)。结论20 Hz rTMS联合奥氮平治疗4周,能有效地改善精神分裂症患者阴性症状及注意力、记忆力,优于单用奥氮平治疗,且安全性较好。
Objective To investigate the efficacy and safety of 20 Hz repetitive transcranial magnetic stimulation(rTMS)combined with Olanzapine in the treatment of psychiatric symptoms and cognitive function in patients with schizophrenia.Methods Seventy-five psychiatric inpatients in No.988 Hospital of Joint Logistic Support Force were selected and divided into study group of 38 cases and control group of 37 cases according to random number table.The study group received stimulation of the left dorsolateral prefrontal cortex(DLPFC)with 20 Hz rTMS combined with Olanzapine,while the control group received Olanzapine alone.Mental symptoms were assessed by Positive and Negative Syndrome Scale(PANSS)before treatment and 4 weeks after treatment,cognitive functions such as attention and memory were assessed by exploratory eye movement(EEM),and safety was assessed by Treatment Emergent Symptom Scale(TESS).Results After 4 weeks of treatment,the total score of PANSS scale,positive symptom score,negative symptom score and general symptom score of 2 groups were all lower than before treatment,with statistical significance(P<0.05).After 4 weeks of treatment,the total score(47.68±4.17),negative symptom score(12.24±1.98)and general symptom score(20.18±3.48)of the study group were lower than those of the control group(53.42±4.66),(14.35±2.21),(23.47±3.89).The difference was statistically significant(P<0.05).After 4 weeks of treatment,NEF score,RSS score of exploratory eye movement increased and D value decreased in both groups,and the differences were statistically significant compared with those before treatment(P<0.05).The NEF score(31.82±4.42)and RSS score(10.56±2.37)in the study group were higher than those in the control group(28.42±3.98)and(8.25±2.19),and the D value score(-0.89±1.56)was lower than that in the control group(1.08±1.28),with difference of statistical significance(P<0.05).Conclusion 20 Hz rTMS combined with Olanzapine for 4 weeks can effectively improve the negative symptoms,attention and memory of patients with schizophrenia,which is better than Olanzapine alone,with good safety.
作者
胡伟
段惠峰
甘景梨
梁学军
Hu Wei;Duan Huifeng;Gan Jingli;Liang Xuejun
出处
《中国疗养医学》
2022年第9期916-919,共4页
Chinese Journal of Convalescent Medicine
基金
河南省医学科技攻关计划科研项目(LHGJ20200791)。
关键词
重复经颅磁刺激
奥氮平
认知功能
阴性症状
20 Hz repetitive transcranial magnetic stimulation(20 Hz rTMS)
Olanzapine
Cognitive function
Negative symptom
