氨磺必利联合重复经颅磁刺激治疗首发精神分裂症的随机对照研究

Clinical controlled study on amisulpride combined with repetitive transcranial magnetic stimulation in the treatment of first-episode schizophrenia

目的探讨氨磺必利合并重复经颅磁刺激(r TMS)治疗精神分裂症的效果。方法采用随机数字表法将符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的88例首发精神分裂症患者分为研究组和对照组各44例,研究组采用氨磺必利联合重复经颅磁刺激(rTMS)治疗,对照组单用氨磺必利治疗,采用阳性与阴性症状量表(PANSS)于治疗前及治疗后第2、4、6、8周评定疗效,采用副反应量表(TESS)评定不良反应。结果经8周治疗,两组PANSS总评分均较治疗前低(P均<0.01)。研究组与对照组有效率分别为88.6%和81.8%,差异无统计学意义(P>0.05)。但研究组阴性症状评分减分与对照组比较,差异有统计学意义(P<0.05)。治疗结束时两组TESS评分差异无统计学意义(P>0.05)。结论氨磺必利合并r TMS对首发精神分裂症阳性症状的疗效与单用氨磺必利相当,而对首发精神分裂症的阴性症状的疗效优于单用氨磺必利,两组不良反应相当。

Objective To investigate the clinical efficacy of amisulpride combined with Repetitive Transcranial Magnetic Stimu-lation(rTMS)for patients with first - episode schizophrenia. Methods Using random number table,88 patients of first - episode schizophrenia were randomly assigned to study group(44 cases)and control group(44 cases),the study group was treated with amisulpride combined with rTMS,and the control group was treated with amisulpride. The efficacy were assessed by Positive and Nega-tive Syndrome Scale(PANSS)before and after treatment for 2,4,6,8 weeks,and the adverse reactions were evaluated with Treatment Emergent Symptom Scale(TESS). Results After 8 weeks treatment,the scores of PANSS in both groups decreased significantly com-pared to the baseline(P < 0. 01). The effective rate of study group and control group were 88. 6% and 81. 8% ,no significant differ-ence was found in effective rate between the two groups(P > 0. 05). The scores of negative symptom in study group decreased signifi-cantly compared to the control group,and there was statistically significant difference(P < 0. 05). By the end of the treatment,no sta-tistically significant difference was found in TESS score between the two groups(P > 0. 05). Conclusion Amisulpride combined with rTMS is as effective as amisulpride for the treatment of positive symptoms of first - episode schizophrenia patients,but it is more effec-tive than amisulpride in the treatment of the negative symptoms.