摘要
目的探讨对以阴性症状为主的精神分裂症患者实施无抽搐性电休克与经颅磁刺激联合治疗的效果.方法将154例以阴性症状为主的精神分裂症患者按照随机数字表分为药物组(33例)、电休克组(39例)、磁刺激组(40例)、联合组(42例),均采用氯丙嗪、阿立哌唑治疗,电休克组、磁刺激组、联合组另分别给予无抽搐性电休克、经颅磁刺激、无抽搐性电休克联合经颅磁刺激治疗.比较治疗前后阴性症状量表(SANS)量化评分变化,临床疗效,并以副反应量表(TESS)评价安全性.结果4组治疗后情感平淡/迟钝、思维匮乏、意志缺乏、兴趣/社交缺乏、注意障碍维度评分、SANS量表总分均降低,与治疗前比较差异均有统计学意义(P<0.05),且治疗后联合组上述评分均低于电休克组、磁刺激组和药物组,电休克组和磁刺激组均低于药物组,差异均有统计学意义(P<0.05),而电休克组和磁刺激组治疗后上述评分均相近,差异无统计学意义(P>0.05);联合组总有效率高于电休克组、磁刺激组和药物组,电休克组和磁刺激组均高于药物组,差异均有统计学意义(P<0.05),而电休克组和磁刺激组总有效率,差异无统计学意义(P>0.05);4组TESS量表评分差异无统计学意义(P>0.05).结论对以阴性症状为主的精神分裂症患者在药物治疗基础上采用无抽搐性电休克和经颅磁刺激治疗均有一定疗效,且联合应用能够增强对阴性症状的控制作用和效果,安全可靠.
Objective To explore the effect of non-convulsive electroconvulsive combined with transcranial magnetic stimulation in schizophrenic patients with negative symptoms mainly. Methods 154 schizophrenic patients with negative symptoms mainly were randomly divided into drug group(33 cases),electroshock group(39 cases),magnetic stimulation group(40 cases)and combined group(42 cases),who were treated with chlorpromazine and aripiprazole. The electroshock group,magnetic stimulation group and combined group were treated with non-convulsive electroshock,transcranial magnetic stimulation,non-convulsive electroshock combined with transcranial magnetic stimulation respectively. The changes of Scale for the Assessment of Negative Symptoms(SANS)quantitative scores before and after treatment and clinical efficacy were compared,and the safety was evaluated by Treatment Emergent Symptoms Scale(TESS). Results After treatment,the affective dullness/dullness,lack of thinking, lack of will,interest/social deficit,attention disorder dimension scores and total scores of SANS scale in the 4 groups were all decreased,with statistically significant differences compared with those before treatment(P<0.05). After treatment,the above scores in the combined group were lower than those in the electroshock group,the magnetic stimulation group and the drug group,which in the electroshock group and the magnetic stimulation group were lower than those in the drug group,with statistically significant differences(P<0.05). However,there was no significant difference in the scores between electroshock group and magnetic stimulation group(P>0.05). The clinical efficacy and the total effective rates of the 4 groups were statistically significant(P<0.05). The total effective rate of the combined group was higher than the electroshock group,the magnetic stimulation group and the drug group,which in the electroshock group and the magnetic stimulation group were higher than those in the drug group,with statistically significant differences(P<0.05). The total effective rate of electroshock group and magnetic stimulation group was similar,and the difference was not statistically significant(P>0.05). There was no significant difference in the scores of TESS among the 4 groups(P>0.05). Conclusion It is effective to treat schizophrenic patients with negative symptoms mainly by non-convulsive electroshock and transcranial magnetic stimulation based on the drug treatment, and the combination application can enhance the control effect and effect of negative symptoms,which is safe and reliable.
出处
《浙江临床医学》
2019年第9期1243-1245,共3页
Zhejiang Clinical Medical Journal
关键词
无抽搐性电休克
经颅磁刺激
精神分裂症
阴性症状
Non convulsive electroconvulsive
Transcranial magnetic stimulation
Schizophrenia
Negative symptoms
