重复经颅磁刺激联合帕利哌酮对精神分裂症患者认知功能的影响

Effect of repetitive transcranial magnetic stimulation combined with paliperidone on cognitive function of schizophrenic patients

目的探讨重复经颅磁刺激(rTMS)联合帕利哌酮缓释片对精神分裂症患者认知功能的疗效及安全性。方法选择符合入组条件的首发精神分裂症患者61名,随机分成治疗组30例(帕利哌酮缓释片联合rTMS),对照组31例(单纯药物)。分别于治疗前及治疗4周后应用阳性与阴性症状量表(PANSS)评定临床症状;应用数字划消测验(CT)、修订版韦氏记忆量表(WMS-RC)、威斯康星卡片分类测验(WCST)分别评定患者的注意功能、记忆功能及执行功能。结果治疗后,两组PANSS总分均低于治疗前,治疗组总分明显低于对照组(P<0.01);两组CT、WMS-RC各指标的得分均优于治疗前(P<0.01),治疗组明显高于于对照组(P<0.05);治疗组WCST各项评分优于治疗前,对照组总应答数、持续错误数、非持续性错误数较治疗前明显降低(P<0.05);治疗组的总应答数、持续错误数及非持续性错误数明显低于对照组(P<0.05)。两组均未出现明显副反应。结论重复经颅磁刺激联合帕利哌酮缓释片对改善精神分裂症患者的认知功能有增效作用,安全性好。

Obiectives To investigate the efficacy and safety of rTMS combined with palisperidone sustained release tablets for cognitive function in patients with schizophrenia.Methods 61 first episode schizophrenic patients were randomly divided into 30 cases in the treatment group(paliperidone combined with rTMS)and 31 in the control group(simple drugs).Before and after treatment for 4 weeks,PANSS was used to assess clinical symptoms.CT,WMS-RC and WCST to evaluate the patient's attention function,memory function and executive function.Results After treatment,the total score of PANSS in both groups was lower than that before treatment,and the total score of the treatment group was significantly lower than that of the control group(P<0.01).The CT and WMS-RC scores of the two groups were better than before treatment(P<0.01),the treatment group was higher than the control group(P<0.05).The WCST scores of the treatment group were better than before treatment,and the total number of responses,persistent errors,and non-persistent errors in the control group were significantly lower than before treatment(P<0.05).The number of sexual errors was significantly lower than that of the control group(P<0.05).There were no obvious side effects in both groups.Conclusion rTMS combined with paliperidone sustained-release tablets has a synergistic effect on improving the cognitive function of patients with schizophrenia and has good safety.