低频重复经颅磁刺激治疗急性期精神分裂症幻听的疗效及安全性研究

目的]探讨低频重复经颅磁刺激合并利培酮治疗急性期精神分裂症幻听的疗效及其安全性。方法]采用随机数字表将90例入住于江西省精神病院的精神分裂症患者随机入组利培酮组、假性经颅磁刺激合并利培酮组及真性经颅磁刺激合并利培酮组,使用阳性和阴性症状评定量表(PANSS)、治疗中出现的症状量表(TESS)及AHRS听幻觉量表分别于入组时、治疗第2周、治疗第4周、治疗第6周及治疗第8周对患者进行评定。结果]①相同治疗时间点真性刺激组幻听评分低于利培酮组和假性刺激组,治疗后4周差异有统计学意义(P﹤0.05),患者的听幻觉症状在相同治疗方式下不同治疗时间点之间差异均有统计学意义(P﹤0.01);②相同治疗时点真性刺激组PANSS量表总分和阳性症状分评分低于利培酮组和假性刺激组,治疗后8周差异有统计学意义(P﹤0.05),患者在相同治疗方式下不同治疗时间点变化趋势不全同(P﹤0.05);③不同治疗方式精神分裂症患者TESS评分各因子分比较差异无统计学意义(χ2=0.797,P﹥0.05)。结论低频重复经颅磁刺激合并利培酮治疗急性期精神分裂症幻听疗效肯定,安全性好。

THE EFFECT AND ITS SAFETY OF SLOW REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION IN THE TREATMENT OF AUDITORY HALLUCINATIONS AT ACUTE PHASE OF SCHIZOPHRENIA

Objective]To explore the effects and its safety of slow repetitive transcranial magnetic stimulation(rTMS)for treating auditory hallucinations at acute phase of schizophrenia.Methods]Ninety schizophrenic patients with auditory hallucinations at acute phase were divided to active slow rTMS group,sham rTMS group and control group by means of random number table.The effects were assessed by the Positive and Negative Syndrome Scale(PANSS),Treatment Emergent Symptom Scale(TESS)and Auditory Hallucination Rating Scale(AHRS)at baseline and the beginning of the second week,fourth week,week eighth week.Results]①About the scores of AHRS,the scores of active slow rTMS group were lower than other group’s at the same time,there were significances after four weeks treatment(P﹤0.05),and there were significances at different time of the same treatment(P﹤0.01);②In terms of total scores and the positive factor scores of PANSS,the scores of active slow rTMS group were lower than other group’s at the same time,and there were significances after eight weeks treatment(P﹤0.05),they varied differently at different time of the same treatment(P﹤0.05);③There were no differences among the groups about the scores of TESS(χ2 = 0.797,P﹥0.05).Conclusion]Slow rTMS is highly safe,coefficient and effective for treating auditory hallucinations at acute phase of schizophrenia.