改良电休克联合高频rTMS在精神分裂症患者中的应用效果及对患者认知功能的影响

The Application Effect of Improved Electroconvulsive Therapy Combined with High-frequency rTMS in Patients with Schizophrenia and its Impact on Cognitive Function

【目的】探讨改良电休克(MECT)联合高频重复经颅磁刺激(rTMS)在精神分裂症(SCH)患者中的应用效果及对认知功能的影响。【方法】选取2021年1月至2023年6月本院收治的88例精神分裂症患者,采用随机数字表法将其分为观察组和对照组,每组44例。两组均给予常规药物,对照组给予MECT+高频rTMS无刺激治疗,观察组给予MECT+高频rTMS治疗。比较两组患者疗效、蒙特利尔认知评估量表(MoCA)评分、阳性和阴性症状量表(PANSS)评分、血清神经递质[Y-氨基丁酸(GABA)、多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)]水平、生活质量综合评定问卷(GQOLI-74)评分及不良反应发生情况。【结果】观察组临床有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组阳性症状评分、阴性症状评分、一般精神病理症状评分、总分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组GQOLI-74、MoCA评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清NE、GABA、5-HT、DA水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】高频rTMS治疗精神分裂症效果显著,可调节神经递质表达,改善患者认知功能,减轻精神症状,提高生活质量。

【Objective】To explore the application effect of modified electroconvulsive therapy(MECT)combined with high-frequency repetitive transcranial magnetic stimulation(rTMS)in patients with schizophrenia(SCH)and its impact on cognitive function.【Methods】A total of 88 patients with schizophrenia admitted to our hospital from January 2021 to June 2023 were selected and randomly divided into an observation group and a control group using a random number table method,with 44 cases in each group.Both groups were given conventional drugs,the control group was given MECT+high-frequency rTMS non irritating treatment,and the observation group was given MECT+high-frequency rTMS treatment.We compared the efficacy,Montreal Cognitive Assessment Scale(MoCA),Positive and Negative Symptom Scale(PANSS),serum neurotransmitters[Y-aminobutyric acid(GABA),dopamine(DA),norepinephrine(NE),5-hydroxytryptamine(5-HT)],GQOLI-74 scores,and incidence of adverse reactions between two groups.【Results】The clinical effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the positive symptom score,negative symptom score,general psychopathological symptom score,and total score of the two groups decreased compared to before treatment.The observation group was lower than the control group,and the difference was statistically significant(P<0.05).After treatment,the GQOLI-74 and MoCA scores of both groups were higher than before treatment,and the observation group was higher than the control group,with a statistically significant difference(P<0.05).After treatment,the serum levels of NE,GABA,5-HT,and DA in both groups were higher than before treatment,and the observation group was higher than the control group,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).【Conclusion】High frequency rTMS has a significant therapeutic effect on schizophrenia,regulating neurotransmitter expression,improving cognitive function,alleviating psychiatric symptoms,and improving quality of life.