超低频经颅磁刺激在治疗以阴性症状表现为主的精神分裂症患者中的作用

The role of infra-low frequency transcranial magnetic stimulation in the treatment of schizophrenia patients mainly with negative symptoms

目的探讨超低频经颅磁刺激(ILF-TMS)在治疗以阴性症状表现为主的精神分裂症患者中的作用。方法纳入2018年1—12月绍兴市第七人民医院精神科收治的符合国际疾病分类第10版(ICD-10)精神与行为障碍分类之精神分裂症诊断标准,并以阴性症状表现为主的206例随机分为观察组(n=104)和对照组(n=102),观察组予ILF-TMS联合口服宁神温胆汤治疗,对照组单独口服宁神温胆汤治疗,共观察8周。于干预前、干预后采用PANSS量表分值评定精神康复、以PANSS减分率判定临床疗效,PSP量表分值评定个人与社会功能康复,TESS量表评定不良反应。结果两组PANSS总分及各因子分在干预后分值均有降低,但观察组下降快于对照组;观察组临床疗效高于对照组,差异均有统计学意义(P<0.05)。经PSP测评,两组个人和社会功能康复在干预后均有上升,但观察组高于对照组,组间比较,差异有统计学意义(P<0.05)。通过TESS量表测评两组治疗8周内的不良反应,观察组出现头晕1例;对照组出现头晕3例,差异无统计学意义(P>0.05)。结论ILF-TMS能有效促进以阴性症状表现为主的精神分裂症患者治疗效果,且无重大不良反应出现,值得临床推广。

Objective To investigate the role of Infra-Low Frequency Transcranial Magnetic Stimulation(ILF-TMS)in the treatment of schizophrenia patients mainly with negative symptoms.Methods From January to December 2018 a total of 206 patients mainly with negative symptoms who met diagnostic criteria of schizophrenia in the 10th edition of the International Classification of Diseases(ICD-10)Classification of Mental and Behavioral Disorders were randomly divided into observation group(n=104)and control group(n=102).The observation group was treated with ILF-TMS combined with oral Ningshen Wendan Decoction,and the control group was treated with Ningshen Wendan Decoction alone.They were observed for 8 weeks.Before and after the intervention,the PANSS scale score was used to evaluate mental rehabilitation,the PANSS score reduction rate was used to determine the clinical efficacy,the PSP scale score was used to evaluate personal and social rehabilitation,and the TESS scale was used to evaluate adverse reactions.Results The PANSS total score and each factor score of the observation group and the control group decreased after the intervention,but the scores of the observation group decreased faster than those of the control group.The clinical efficacy of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After the PSP test,the observation group and the control group both increased after the intervention,but the observation group rose faster than the control group.The difference between the groups was statistically significant(P<0.05).The TESS scale was used to evaluate the adverse reactions within 8 W of treatment in the two groups.One case of dizziness occurred in the observation group;3 cases of dizziness occurred in the control group.After chi-square test,the difference was not statistically significant(P>0.05).Conclusion ILF-TMS can effectively promote the treatment effect of schizophrenia patients mainly with negative symptoms,without major adverse reactions,and is worthy of clinical promotion.