抗精神病药物联合MECT治疗精神分裂症伴顽固性幻听临床研究

Antipsychotics combined with MECT in the treatment of re- fractory auditory hallucination of schizophrenics

目的探讨抗精神病药物联合无抽搐电休克治疗精神分裂症伴顽固性幻听患者的临床疗效和安全性。方法对36例精神分裂症伴顽固性幻听患者在维持原用抗精神病药物治疗的基础上联合无抽搐电休克治疗，观察8周。采用阳性与阴性症状量表评定临床疗效，韦氏记忆量表评定记忆状况，副反应量表评定不良反应。结果本组患者治疗1周末起，阳性与阴性症状量表幻听因子分较治疗前显著下降，4周末起总分及各因子分均较治疗前显著下降（P〈0．01）；治疗2周末韦氏记忆量表的再认、图片、联想及背数记忆4个因子分均显著低于治疗前（P〈0．05），但治疗4周、8周末与治疗前比较差异均无显著性（P〉0．05）；副反应量表评分治疗前后比较差异无显著性（P〉0．05）。结论抗精神病药物联合无抽搐电休克治疗精神分裂症伴顽固性幻听患者疗效显著，起效快，对记忆的影响是短暂的、可逆的，不良反应轻微，安全性高。

Objective To explore the efficacy and safety of antipsychotics combined with modified electro- convulsive therapy （MECT） in the treatment of refractory auditory hallucination of schizophrenics. Meth- ods Thirty-six schizophrenics with refractory auditory hallucination received antipsychotics plus MECT 8 weeks. Efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS）, memory status with the Wechsler Memory Scale （WMS）, and adverse reactions with the Treatment Emergent Symptoms Scale （TESS）. Results Auditory hallucination score of the PANSS lowered more significantly since the end of the 2nd week, so did the total and other factor score since the end of the 4＇h week compared with pre- treatment （P〈0.01）; recognition,card,association and digit span of the WMS were significantly lower at the end of the 2nd week compared with pretreatment （P〈0.05）, but there were no significant differences in them at the end of the 4th and 8th week （P）0.05） ; pre- and post-treatment TESS score had no difference （P〈0.05）. Conclusion Antipsychotics plus MECT have an evident effect, take effect more rapidly, their influences on memory are transitory and reversible, their adverse reactions are mild, and has higher safety.