重复经颅磁刺激联合拉莫三嗪对精神分裂症顽固性幻听辅助治疗作用的对照研究

目的:探讨重复经颅磁刺激(r TMS)联合拉莫三嗪辅助治疗精神分裂症患者顽固性幻听的临床疗效。方法:90例精神分裂症患者随机分为观察组、对照1组和对照2组,每组各30例。观察组给予r TMS和拉莫三嗪治疗,对照1组给予伪r TMS和拉莫三嗪治疗,对照2组则给予r TMS和安慰剂治疗,连续观察8周。采用阳性和阴性症状量表(PANSS)、听幻觉量表(AHRS)和治疗中出现的症状量表(TESS)于治疗前和治疗后4、8周评定疗效和不良反应。结果:治疗8周,观察组PANSS及AHRS总分均显著低于对照1组和对照2组,组间主效应明显(F=6.739,P0.01;F=3.898,P0.05);各组PANSS总分及AHRS总分具有时间主效应(F=30.383,F=18.232;P均0.001),但组间与时间均无交互作用(F=1.607,F=1.568;P0.05)。观察组与对照组不良反应发生率差异无统计学意义(χ2=0.752,P0.05)。结论:r TMS联合拉莫三嗪辅助治疗能够显著地改善精神分裂症患者顽固性幻听症状,其疗效优于单用r TMS或拉莫三嗪。

Control study in the clinical efficacy of rePetitive transcranial magnetic stimulation combined with lam-otrigine in the treatment of obstinate auditory hallucination exPerienced by schizo Phrenic Patients

Objective:To explore the clinical efficacy of repetitive transcranial magnetic stimulaton(rT-MS)combined with lamotrigine in the treatment of obstinate auditory hallucinations experienced by schizophren-ic patients. Method:Ninety schizophrenic patients were randomly divided into observation group(n = 30), control group 1(n = 30)and control group 2(n = 30). The observation group was administered rTMS and lam-otrigine,control group 1 was administered unreal rTMS and lamotrigine,and control group 2 was administered rTMS and placebo. The course of all administrations was 8 weeks. Before the treatment,at the 4th week,and at the 8th week. Clinical efficacies were assessed with the positive and negative symptom scale(PANSS)and audi-tory hallucinations rating scale( AHRS),and adverse reactions with the treatment emergent symptom scale (TESS). Results:At the end of treatment period,the total score of PANSS and AHRS for observation group were lower than that of control group 1 and than that of control group 2,and the differences between observation group and control groups were statistically significant(F = 6. 739,P < 0. 01;F = 3. 898,P < 0. 05);the total score of PANSS and that of AHRS for each of the three groups showed main effect of time(F = 30. 383,F =18. 232;all P < 0. 001),but there were no time × group interaction effect( F = 1. 607,F = 1. 568;all P >0. 05);no significant difference was found adverse reactions between observation group and control groups(χ2 =0. 752,P > 0. 05). Conclusion:rTMS combined with lamotrigine has more evident clinical effecacy than the single use of rTMS or lamotrigine on schizophrenia with obstinate auditory hallucination.