重复经颅磁刺激联合氯氮平及帕利哌酮治疗难治性精神分裂症的临床疗效观察

Observation of clinical efficacy of repetitive transcranial magnetic stimulation combined with clozapine and paliperidone in the treatment of refractory schizophrenia

目的探讨重复经颅磁刺激(rTMS)联合氯氮平及帕利哌酮治疗难治性精神分裂症的治疗效果.方法依据随机数字表法,将2019年6月-2020年6月东乡区第二人民医院收治的难治性精神分裂症患者92例分成两组.对照组(n=46)予以氯氮平和帕利哌酮治疗,观察组(n=46)在此基础上加用rTMS治疗,对比两组临床疗效、认知功能与记忆功能以及不良反应.结果观察组治疗总有效率为82.61%,高于对照组的63.04%(P<0.05);治疗前,两组认知功能与记忆功能水平相比,差异无统计学意义(P>0.05);治疗后,观察组认知功能与记忆功能评分分别为(94.76±3.89)分、(93.41±2.97)分,高于对照组的(88.71±3.12)分、(86.43±2.48)分(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05).结论rTMS联合氯氮平与帕利哌酮治疗难治性精神分裂症患者效果显著,可改善其临床症状,提高认知功能.

Objective To investigate the therapeutic effect of repetitive transcranial magnetic stimulation(rTMS)combined with clozapine and paliperidone in the treatment of refractory schizophrenia.Methods According to the random number table method,92 patients with refractory schizophrenia who were admited to our hospital from June 2019 to June 2020 were divided into two groups.The control group(n=46)was treated with clozapine and paliperidone,and the observation group(n=46)was additionally treated with rTMS.The clinical efficacy,cognitive function and memory function,and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 82.61%,which was higher than 63.04% in the control group(P<0.05).Before treatment,the levels of cognitive function and memory function in the two groups were compared(P>0.05).The scores of cognitive function and memory function were(94.76±3.89)points and(93.41±2.97)points,respectively,which were higher than those of the control group(88.71±3.12)points and(86.43±2.48)points(P<0.05).The incidence rate was compared(P>0.05).Conclus ion rTMS combined with clozapine and paliperidone has a significant effect in the treatment of refractory schizophrenia,and can improve their clinical symptoms and cognitivefunction.