摘要
目的探讨利培酮联合重复经颅磁刺激（rTMS）治疗首发精神分裂症的临床疗效，并观察其安全性及不良反应。方法将60例首发精神分裂症患者随机分成研究组和对照组，研究组在利培酮基础上联合rTMS真刺激，对照组在利培酮基础上联合rTMS假刺激干预。分别于治疗前、治疗1周、2周及4周应用阳性和阴性症状量表（PANSS）评定临床疗效，采用不良反应量表（TESS）、生命体征、体格检查、临床实验室检查、心电图、脑电图评价安全性。结果研究组和对照组PANSS总分及各因子分在治疗1周、2周及4周均显著下降（P〈0．01）；研究组的有效率在治疗2周时即高于对照组，差异具有统计学意义（P〈0．01），而两组有效率在4周时差异无统计学意义（P=0．127）；研究组阳性症状因子评分在治疗2周时即显著低于对照组（P〈0．05），在4周末时差异有统计学显著性（P〈0．01）。研究组和对照组在治疗中均无严重不良反应发生，两组不良反应差异无统计学意义。结论重复经颅磁刺激具有很好的安全性，联合利培酮使用可以提高治疗首发精神分裂症的疗效，尤其有助于改善阳性症状。
Objective To investigate the therapeutic effects and the safety of repetitive transcranial magnetic stimulation （rTMS） combined with risperidone on first-episode schizophrenic patients. Methods 60 first-episode schizophrenia patients were randomly divided into two groups to receive risperidone plus active-rTMS or risperidone plus sham-rTMS for 4 weeks. The Positive and Negative Symptom Scale （PANSS） was utilized for evaluating clinical efficacy, and the Treatment Emergent Symptom Scale （TESS）utilized for evaluating the safety at the end of weeks 1,2 and 4. Moreover,medical examination, electrocardiogram and electroencephalogram examination were performed at week 1 and 4 for safety evaluation. Results There＇s a significant decline on the total PANSS score in both active and sham group at the end of week 1,2 and 4. The efficacy of active treatment is statistically more significant than that of the sham treatment at the end of week 2 （P 〈 0.01）, but there is no difference between the two treatments at the end of week 4 （P 〈0. 127）. The positive symptom score of active group was lower than that of sham group at the end of weeks 2 （P〈0.05） and 4 （P〈0.01）, and the total score of active group was lower than that of sham group at the end of weeks 2 and 4 （P 〈 0.05）. No serious adverse events occurred at the whole treatment period. Conclusions rTMS is a safe and effective treatment method for schizophrenia,and it can increase the effectiveness of risperidone for first-episode schizophrenia.
出处
《神经疾病与精神卫生》
2012年第1期14-17,共4页
Journal of Neuroscience and Mental Health
基金
国家自然科学基金（30870886）资助
关键词
经颅磁刺激
精神分裂症
利培酮
随机对照研究
Transcranial magnetic stimulation
Schizophrenia
Risperidone
Randomized controlled trial
