高频rTMS联合齐拉西酮治疗精神分裂症患者的疗效及对脑源性神经营养因子、认知功能的影响

Effect of high frequency rTMS combined with ziprasidone on patients with schizophrenia and its influence on their brain-derived neurotrophic factor and cognitive function

目的 探讨高频重复经颅磁刺激(rTMS)联合齐拉西酮治疗精神分裂症的效果.方法 选取阜阳市第三人民医院精神科收治的92例精神分裂症患者作为研究对象,随机分为两组,对照组46例采用齐拉西酮治疗,联合组46例采用高频rTMS联合齐拉西酮治疗.比较两组神经功能相关因子指标和临床疗效.结果 ①联合组临床总有效率(89.13%)明显高于对照组(76.09%);②与对照组治疗后比较,联合组治疗后血清胶质纤维酸性蛋白(GFAP)、总胆固醇(TC)、空腹血糖(FPG)水平降低更明显,血清神经生长因子(NGF)、脑源性神经生长因子(BDNF)水平及洛文斯顿作业疗法认知评定成套测验(LOTCA)评分升高更明显,差异具有统计学意义;③两组不良反应发生率无统计学差异(15.21%vs13.04%).结论 高频rTMS联合齐拉西酮治疗精神分裂症患者疗效确切,可提高患者BDNF水平,改善认知功能.

Objective Explore the efficacy of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with ziprasidone in the treatment of schizophrenia.Methods 92 patients with schizophrenia admitted to the Department of Psychiatry at the Third People's Hospital of Fuyang City were selected as the study subjects and randomly divided into two groups.The control group consisted of 46 patients treated with ziprasidone,while the combination group consisted of 46 patients treated with high-frequency rTMS combined with ziprasidone.Compare two groups of neurological function related factor indicators and clinical efficacy.Results The total clinical effective rate of the combined group(89.13%)was significantly higher than that of the control group(76.09%);②Compared with the control group after treatment,the combined group showed a more significant decrease in serum levels of glial fibrillary acidic protein(GFAP),total cholesterol(TC),and fasting blood glucose(FPG),as well as a more significant increase in serum levels of nerve growth factor(NGF),brain derived nerve growth factor(BDNF),and Lowenstein Occupational Therapy Cognitive Assessment Battery(LOTCA)scores after treatment.The differences were statistically significant;③There was no statistically significant difference in the incidence of adverse reactions between the two groups(15.21%vs 13.04%).Conclusion The combination of high-frequency rTMS and ziprasidone has a definite therapeutic effect on schizophrenia patients,which can increase their BDNF levels and improve cognitive function.