rTMS对难治性精神分裂症患者的效果及对血清PRL、BDNF、NGF水平的影响

The efficacy of rTMS as an adjuvant therapy for refractory schizophrenia and its impact on serum PRL,BDNF,and NGF levels

目的研究重复经颅磁刺激(rTMS)辅助治疗对难治性精神分裂症的疗效及其对血清催乳素(PRL)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)含量的影响。方法选取我院2019年1月~2023年1月收治的90例难治性精神分裂症患者作为研究对象,按随机数字表法分为两组,每组各45例,对照组采用口服帕利哌酮片进行治疗,观察组采用口服帕利哌酮片联合rTMS辅助治疗。比较两组疗效,比较两组治疗前后的阳性、阴性症状评分、阳性和阴性症状量表(PANSS)总分,比较两组患者治疗前后血清PRL、BDNF、NGF水平,比较两组患者治疗后的不良反应。结果观察组治疗效果优于对照组(P<0.05);治疗后两组患者阳性症状评分、阴性症状评分、PANSS总分显著下降(P<0.05),治疗后观察组阳性评分、阴性评分、PANSS总分低于对照组(P<0.05);治疗后两组PRL水平与治疗前相比显著下降(P<0.05),BDNF、NGF水平较治疗前显著上升(P<0.05),观察组PRL水平低于对照组,BDNF、NGF水平高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论rTMS辅助治疗难治性精神分裂症的疗效显著,对血清PRL、BDNF、NGF水平有较好的改善作用,安全性高,适用于临床治疗。

Objective To study the efficacy of repetitive transcranial magnetic stimulation(rTMS)as an ad-junctive treatment for refractory schizophrenia and its effect on the levels of serum Prolactin(PRL),Brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF).Methods 90 patients with refractory schizophrenia admitted to our hospital from January 2019 to January 2023 were selected and divided into two groups using a random number table method,with 45 patients in each group,The control group was treated with oral paliperidone tablets,and the observation group was treated with oral paliperidone tablets combined with rTMS.The positive and negative scores,positive and negative symptom scale(PANSS)total scores before and after treatment between the two groups were compared,the levels of serum PRL,BDNF,and NGF and the adverse reactions between two groups of patients before and after treatment were compared.Results The treatment effect of the observation group is better than that of the control group(P<0.05).After treatment,the positive score,negative score,and total PANSS score of the two groups of patients significantly decreased(P<0.05).After treatment,the positive score,negative score,and total PANSS score of the observation group were lower than those of the control group(P<0.05).After treatment,the PRL levels of the two groups of patients significantly decreased compared to before treatment(P<0.05).The levels of BDNF and NGF significantly increased compared to before treatment(P<0.05).The PRL level in the observation group was lower than that in the control group,while the levels of BDNF and NGF were higher than those in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The adjuvant therapy of rTMS has a significant therapeutic effect on refractory schizophrenia,with a good improvement effect on serum PRL,BDNF,and NGF lev-els,high safety,and is suitable for clinical treatment.