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<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.04.005

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1163 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【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。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：精神分裂症/治疗, 经颅磁刺激, 电惊厥疗法, 认知

Abstract：【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.

Key words： Schizophrenia/TH Transcranial Magnetic Stimulation Electroconvulsive Therapy Cognition

收稿日期: 2023-07-05

中图分类号:

R749.3

基金资助:^*军队临床重点专科建设项目(91);联勤医学重点学科建设项目(104);河南省医学科技攻关计划联合共建项目(LHGJ20210816,LHGJ20220906)

通讯作者: ^**E-mail:zhuxiquan@aliyun.com

引用本文:

杜恬恬, 梁学军, 史振娟, 白晶, 段惠峰, 祝希泉. 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^*[J]. 医学临床研究, 2024, 41(4): 496-499.
DU Tiantian, LIANG Xuejun, SHI Zhenjuan, et al. The Application Effect of Improved Electroconvulsive Therapy Combined with High-frequency rTMS in Patients with Schizophrenia and its Impact on Cognitive Function. JOURNAL OF CLINICAL RESEARCH, 2024, 41(4): 496-499.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.04.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I4/496

[1] MASROOR A,KHOROCHKOV A,PRIETO J, et al. Unraveling the association between schizophrenia and substance use disorder-Predictors,mechanisms and treatment modifications: a systematic review[J].Cureus,2021,13(7):16722.
[2] 康敏敏,李婷,黄正元,等.精神分裂症认知障碍与星形胶质细胞关系的研究进展[J].中国现代医学杂志,2020,30(6):52-56.
[3] 刘新生,王仁广,陈红军,等.依托咪酯联合丙泊酚诱导全麻在精神分裂症患者MECT治疗中的应用及安全性分析[J].国际精神病学杂志,2020,47(1):104-106.
[4] 蒲丽,刘可智.高频重复经颅磁刺激治疗以阴性症状为主的精神分裂症患者疗效及其持续时间观察[J].现代中西医结合杂志,2020,29(12):1280-1283.
[5] 中华医学会精神科分会.中国精神障碍分类与诊断标准(CGMD-3)[M].3版.济南:山东科学技术出版社,2001:40-43.
[6] 王欣,张应全,陈军升,等.阴性和阳性症状精神分裂症患者内隐记忆特点及相关因素[J].中华行为医学与脑科学杂志,2021,30(3):232-237.
[7] VITA A,BARLATI S,CERASO A, et al. Effectiveness,core elements,and moderators of response of cognitive remediation for schizophrenia: a systematic review and meta-analysis of randomized clinical trials[J].JAMA Psychiatry,2021,78(8):848-858.
[8] 李群,黄呈隆,蒙淑琼,等.无抽搐性电休克联合抗精神药物对复发精神分裂症急性期患者的临床疗效[J].中南医学科学杂志,2021,49(4):477-480.
[9] 丁梅,施于超,曹雍华,等.阿立哌唑联合MECT对精神分裂症患者甲状腺功能及血清神经营养因子水平的影响[J].临床和实验医学杂志,2021,20(24):2655-2659.
[10] 赵艳丽,黄文倩,石晶,等.重复经颅磁刺激对精神分裂症患者前脉冲抑制功能的影响[J].神经疾病与精神卫生,2020,20(4):235-240.
[11] 王林平,肖岩,杨富增,等.精神分裂症患者高频重复经颅磁刺激治疗后复发的影响因素分析[J].中国医师杂志,2022,24(3):439-442.
[12] 陈天意,刘登堂,介勇,等.重复经颅磁刺激应用于精神分裂症的阴性症状[J].国际精神病学杂志,2020,47(2):233-235.
[13] 范桂红,何俊,庞高峰,等.无抽搐电休克疗法对精神分裂症患者的治疗效果和脑内及不同脑区神经递质水平的影响研究[J].中国全科医学,2022,25(3):325-330.
[14] 方芳,方海红,宋明芬,等.细胞色素P450酶1A2、2D6与多巴胺D₂受体基因多态性对奥氮平治疗精神分裂症PANSS减分率的影响[J].中国现代应用药学,2020,37(13):1621-1624.