摘要
目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对慢性精神分裂症患者精神症状、社会功能和生活质量的影响。方法将符合美国精神障碍诊断与统计手册第4版(diagnostic and statistical manual of mental disorders,fourth edition,DSM-Ⅳ)精神分裂症诊断标准的70例患者随机分为两组,在原非典型抗精神病药物治疗的基础上进行4周10Hz rTMS治疗,一组给予真刺激(研究组,n=37),另一组给予伪刺激(对照组,n=33)。采用阳性和阴性症状量表(positive and negative syndrome scale,PANSS)、住院精神病人社会功能评定量表(scale of social function in psychosis inpatients,SSPI)和精神分裂症病人生活质量量表(schizophrenia quality of life scale,SQLS)于治疗前后分别评估患者的精神症状、社会功能和生活质量。结果治疗前后比较,研究组的PANSS总分、阴性症状分及阴性症状分量表的情绪退缩、被动/淡漠社交退缩、交谈缺乏自发性和流畅性等因子分均降低(t=2.911,P=0.005;t=2.739,P=0.008;t=3.165,P=0.002;t=2.261,P=0.027;t=2.109,P=0.039),且阴性症状分低于对照组治疗后评分(t=2.224,P=0.030),差异有统计学意义。研究组治疗后SSPI总分、动性和交往情况评分高于治疗前(t=2.378,P=0.020;t=2.786,P=0.007),且高于对照组治疗后(t=2.339,P=0.022;t=2.733,P=0.008)。研究组SQLS总分、动力/精力评分低于治疗前(t=2.106,P=0.039;t=3.585,P=0.001),且低于对照组治疗后(t=2.063,P=0.043;t=3.570,P=0.001),差异有统计学意义。对照组治疗前后PANSS、SSPI、SQLS评分比较,差异均无统计学意义(P>0.05)。结论 rTMS有助于减轻慢性精神分裂症患者的情绪退缩、被动/淡漠社交退缩、交谈缺乏自发性和流畅性等阴性症状,改善社会功能,提高生活质量。
Objective To evaluate effects of repetitive transcranial magnetic stimulation （rTMS） on psychiatric symptoms, social function and life quality of chronic schizophrenias patients. Methods Seventy hospitalized patients with chronic schizophrenia who met diagnostic and statistical manual of mental disorders, fourth edition （DSM-IV） were ran- domly divided into study group （n = 37） and control group（n = 33）. All patients received 4 weeks treatment with 10 Hz rTMS based on original antipsychotics treatment. The study group was taken active rTMS, and the control group was un- der sham stimulation. Positive and negative syndrome scale （PANSS）, scale of social function in psychosis inpatients （SSPI） and schizophrenia quality of life scale （SQLS） were used for measuring psychiatric symptoms, social function and life quality of all. patients before and after treatment. Results In study group, PANSS total score, factor scores of nega- tive symptoms, emotional withdrawal, passive/apathetic social withdrawal, and conversation lack of spontaneity and flu- ency obviously decreased after treatment （t = 2. 911, P = 0. 005 ; t = 2. 739, P = 0. 008; t = 3. 165, P = 0. 002; t = 2. 261, P = 0. 027; t = 2. 109, P = 0. 039）, and score of negative symptoms was lower than that in control group （t = 2. 224, P = 0. 030）. In study grout）, SSPI total score and motivation/intercourse score increased significantly after treatment （t =2. 378, P = 0.020; t = 2. 786, P = 0.007）, and were higher than those in control group after treatment （t = 2. 339,P = O. 022; t = 2. 733, P = 0. 008）. SQLS total score and motivation/energy score in study group were decreased after treatment （t = 2. 106, P = 0. 039; t =3. 585, P = 0. 001）, and also lower than those in control group （t = 2. 063, P = 0. 043; t = 3. 570, P = 0. 001）. No differ- enees were found in the scores of PANSS, SSPI and SQLS before and after treatment in control group （P〉0. 05）. Conclusion rTMS may alleviate the negative symptoms of chronic schizophrenia patients, such as emotional withdrawal, pas- sive/apathetic social withdrawal and conversation lack of spontaneity and fluency, improve social function, and increase the quality of life.
出处
《华南国防医学杂志》
CAS
2017年第8期509-513,共5页
Military Medical Journal of South China
基金
全军医学科研计划(CWS12J071)
关键词
重复经颅磁刺激
精神分裂症
康复
Repetitive transcranial magnetic stimulation
Schizophrenia
Rehabilitation
