重复经颅磁刺激联合利培酮治疗精神分裂症疗效及预后对比分析

Comparative studies of repetitive transcranial magnetic stimulation combined with risperidone tablets the treatment response and prognosis of schizophrenia

目的比较重复经颅磁刺激(r TMS)联合利培酮与单一利培酮治疗精神分裂症患者的疗效、安全性、智力状态和社会功能恢复,为临床选择治疗方案提供参考依据。方法选择2015年9月至2016年10月该院诊治的精神分裂症住院患者66例,将其随机分为研究组32例和对照组34例,治疗时间均为6周。在治疗前和治疗后第1、2、4、6周采用阳性与阴性症状量表(PANSS)及减分率评定疗效,同时采用不良反应量表(TESS)评定不良反应,简易智力状态检查(MMSE)评定智力状态,并采用个体和社会功能量表(PSP)评定患者的社会功能。结果治疗前,两组PANSS、MMSE、PSP治疗前评分比较,差异均无统计学意义(P>0.05)。治疗后,在各时点与治疗前比较,两组PANSS、MMSE、PSP均有明显改善,差异均有统计学意义(P<0.01);组间比较,在研究终末,两组PANSS、MMSE、PSP评分比较,差异均有统计学意义(P<0.05)。治疗终点,两组PANSS减分率及疗效比较,差异均有统计学意义(P<0.05),但两组TESS评分比较,差异无统计学意义(P>0.05)。结论 rTMS联合利培酮较单一使用利培酮在疗效、智力状态恢复、社会功能恢复均存在优越性,且在不良反应方面无明显差异。

Objective To compare differences between repetitive transcranial magnetic stimulation （rTMS）combined with rlsperidone tabletsandunique risperidone tablets efficacy, safety, mental state and social functions recovery in the treatment of patients with schizophrenia ,provides the reference for clinical treatment options. Methods Totally 66 eligible patients with schizophrenia were randomly divided into study group and control group ,these cases were treated for 6 weeks. Before treatment （baseline） and after the treatment at the end of 1,2,4,6 weeks, the positive and negative syndrome scale （PANSS） and the reduction rate assess the efficacy, treatment emergent sysptom scale （TESS） assess adverse reactions, mini-mental state examination （MMSE） assess mental state, personal and social performance scale （PSP） assess the patient＇s social function. Results Before treatment, PANSS, MMSE and PSP baseline scores of the two groups had no statistically significant （P〉0.05）. After treatment, compared with respective baseline period, PANSS, MMSE and PSP showed significant improvement at various time pointswith statistically significant （P〈0.01）. There were significant differences in scores of PANSS, MMSE and PSP between the two groups （P〈 0.05 ）. To the end of treatment, the difference of PANSS reduction rate and efficacy was statistically significant in both groups （P〈0.05）. The TESS scores had no significant difference（P〉0.05 ） between the two groups, rTMS and risperidone tablets were safe and well tolerated. Conclusion rTMS combine with risperidone tablets than the single use of risperidone tablets in efficacy, mental state recovery and social function recovery exists superiority, side effects were not significant difference.