无抽搐电休克治疗急性期重性精神病的疗效

Clinical Effect of Modified Electric Convulsive Therapy on Acute Psychosis

目的:探讨无抽搐电休克治疗(MECT)急性期重性精神病的临床疗效。方法:选取2013年12月-2014年1月在攀枝花市第三人民医院6个重症精神病房新住院治疗患者60例,据入院时间先后随机将其分为药物治疗组与MECT组各30例,治疗时间为4周。于治疗前及治疗后1、2、3及4周末分别采用简明精神病评定量表(BPRS)、临床疗效总评量表(CGI-SI)和副反应量表(TESS)评定疗效和治疗副作用。结果:MECT组总有效率(包括痊愈、显效、好转的患者)为96.67%显著高于药物治疗组46.67%的显效率,差异具有显著性(P<0.01)。治疗前两组BPRS评分比较无统计学差异(t=-0.56,P>0.05),在治疗1周(t=3.04,P<0.05)、2周(t=2.75,P<0.05)、3周(t=4.24,P<0.01)及4周后(t=3.89,P<0.01),MECT组BPRS评分显著低于药物治疗组。治疗前及治疗后1周CGI-SI评分无显著差异,在治疗2、3、4周后MECT组CGI-SI评分显著低于药物治疗组(t=9.91,6.79,6.40;P<0.01)。治疗1周(t=2.40,P<0.05)、2周(t=3.35,P<0.05)、3周(t=4.15,P<0.01)及4周后(t=5.53,P<0.01),MECT组不良反应发生率显著低于药物治疗组。结论:MECT疗效优于常规药物治疗且不良反应低于常规药物治疗,是一种有效、安全的治疗方法。

Objective：To explore the clinical effect of modified electric convulsive therapy（ MECT） on acute psychosis.Methods：60 patients with acute psychosis, who were in our hospital from December, 2013 to January,2014,were divided into drug treatment group（ n=30） and MECT treatment group（ n=30） in accordance with the admission time.brief psychiatric rating scale（ BPRS） ,the Clinical Global Im-pression-Severty of Illness（ CGI-SI） and Treatment Emergent Symptom Scale（ TESS） were used to eval-uate the curative effect and side effects before the treatment and 1st,2nd,3rd and 4th week after the treat-ment.Results：The total efficiency of the MECT treatment group was 96.67% ,which was significantly higher than that of drug treatment group（46.67%） （P 〈0.01）.There was no significant change in BPRS between two groups before the treatment.BPRS in MECT treatment group was significantly lower than that in the drug treatment group after 1 week （t=3.04,P〈0.05）,2 week（t=2.75,P〈0.05）,3 week （t=4.24,P〈0.01）and 4 week treatment（t=3.89,P〈0.01）.The difference in CGI-SI score was no statistical significant between the two groups before and 1 week after the treatment.CGI-SI in MECT treatment group were significantly lower than those in the drug treatment group after 2 week （ t=9.91,P〈0.01）,3 week （t=6.79,P〈0.01）and 4 week treatment（t=6.40,P〈0.01）.Significant lower incidences of adverse reactions to the drug were observed in the patients in MECT treatment group compared with drug treatment group at 1 week（t=2.40,P〈0.05）,2week（t=3.35,P〈0.05）,3week （t=4.15,P〈0.01） and 4 week （t=5.53,P 〈0.01） after the treatment.Conclusion：The effect of MECT is superior to the conventional drug treatment and the side effect of MECT is lower than that of conventional drug treatment,MECT is a safe and effective treatment method for acute psychosis.