低频重复经颅磁刺激联合奥氮平治疗首发精神分裂症临床疗效分析

Effect of low-frequency repetitive transcranial magnetic stimulation combined with Olanzapine in first-episode schizophrenic patients

目的探讨了低频重复经颅磁刺激联合奥氮平治疗首发精神分裂症的临床疗效和安全性。方法将2010年6月到2013年6月来我院接受治疗的216例首发精神分裂症患者随机分为对照组和观察组,观察组给予右前额叶背外侧区低频r TMS刺激,对照组给予相同参数的r TMS假刺激。两组在上述治疗基础上均接受相同剂量的奥氮平。分别采用阳性和阴性症状量表(PANSS)、韦氏记忆量表(WMS-R)和治疗中需处理的不良反应量表(TESS)对两组患者治疗前后的临床疗效、认知和不良反应进行评定。结果对照组在治疗4周后PNASS量表各维度评分较治疗前显著下降(P<0.05),而观察组治疗2周后PNASS量表各维度评分较治疗前显著下降(P<0.05)。与对照组比较,治疗后观察组PNASS量表各维度评分下降更显著(P<0.05)。观察组治疗有效率明显高于对照组(P<0.05)。观察组在短时记忆和瞬时记忆等认知功能方面优于对照组(P<0.05)。对照组和观察组患者治疗期间不良反应的发生率比较无统计学意义(P>0.05)。结论低频重复经颅磁刺激联合奥氮平治疗精神分裂症疗效显著,安全可靠,值得临床推广使用。

Objective To explore effect and safety of low-frequency repetitive transcranial magnetic stimu- lation combined with Olanzapine in first-episode schizophrenic patients. Methods 216 first-episode schizophrenic patients from June 2008 to June 2010 were randomly divided into control group and observe group in our hospital. The patients in control and observe group received Olanzapine. Patients in observe group were given additional low -fiequeney repetitive transcranial magnetic stimulation treatment. Patients in control group were given dummy stim- ulation, efficacy was assessed by the Positive and Negative symptom scale （PANSS）. Cognitive function was as- sessed by Wechsler Memory Scale （WMS-R）. Side effect were analyzed by Treatment emergent scale （TESS）. Results Compared with before treatment, the PANSS scores in control group after treatment significantly de- creased from the forth week （P〈0. 05 ）, but those in observe group significantly decreased from the second week （P〈0. 05）. Compared with control group, the PANSS scores in observe group significantly decreased （P〈0. 05）. efficiency ratio higher than control group （P〈0. 05）. The short term memory and immediate memory function was better than control group （P〈0.05）. There is no significant difference between control group and observe group in side effects. Conclusion Low-frequency repetitive transcranial magnetic stimulation combined with Olanzapine effect than drug monotherapy and safety in first-episode schizophrenic patients.