不同强度高频重复经颅磁刺激对慢性精神分裂症阴性症状的影响-现代医学

不同强度高频重复经颅磁刺激对慢性精神分裂症阴性症状的影响

单位：常熟市第三人民医院七病区, 江苏常熟 215500

分类号：R749.3

出版年·卷·期（页码）：2017·36·第十一期（1587-1590）

摘要：

目的：观察不同强度高频经颅磁刺激（rTMS）对慢性精神分裂症阴性症状的疗效及安全性。方法：将60例慢性精神分裂症患者随机分为高强度组和低强度组，在原抗精神病药基础上，分别联用110%或80%运动阈值（MT）的高频rTMS，每周治疗5次，连续治疗6周。在基线期和治疗第3、6周末采用阳性和阴性症状量表（PANSS）及阴性症状量表（SANS）评估疗效，副反应量表（TESS）评估安全性。结果：两组PANSS阴性量表分、阴性量表各项症状分及SANS总分、分量表综合评价总分、各分量表综合评价分在第6周末均低于基线期（P<0.05或P<0.01），其中高强度组上述量表分（除抽象思维困难、刻板思维和思维贫乏总评）在第3周末均低于低强度组（P<0.05或P<0.01）。两组间不良反应差异无统计学意义（P>0.05）。结论：高频rTMS能有效治疗慢性精神分裂症阴性症状，安全性好且高刺激强度起效更快。

Objective:To observe the efficacy and safety of antipsychotics combined with different intensity high-frequency repetitive transcranial magnetic stimulation(rTMS) in the treatment of chronic schizophrenia with negative symptoms. Methods:Sixty chronic schizophrenia patients were randomly divided into two groups. On top of antipsychotics, they underwent high frequency rTMS of 80% or 110% of motor threshold (MT) respectively and were treated 5 times a week for 6 weeks. The Positive and Negative Syndrome Scale(PANSS) and the Scale for Assessment of Negative Symptoms(SANS) were utilized for evaluating clinical efficacy, and the Treatment Emergent Symptoms Scale(TESS)was utilized for evaluating the safety at baseline and in the 3rd, the 6th week after treatment. Results:At the end of the 6th week, negative factor score of PANSS, negative factor score of various symptoms scale, SANS total score, global rating score of subscale and global rating of subscale in the two groups were lower compared with those of the baseline assessment(P<0.05 or P<0.01). At the end of the 3rd week, the scale scores(except difficulty in abstract thinking, stereotyped thinking and Alogia) in 110% MT group were lower than those in 80% MT group (P<0.05 or P<0.01). There were no significant differences of side effects between the two groups (P>0.05). Conclusion:High-frequency rTMS is effective and safe in the treatment of chronic schizophrenia with negative symptoms, and high MT works faster.

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