重复经颅磁刺激治疗难治性精神分裂症的增效作用研究

目的 探索分析重复经颅磁刺激（repetitive transcranial magnetic stimulations，rTMS）治疗难治性精神分裂症增效作用的随机双盲对照研究。方法 以2014年1月至2015年2月在首都医科大学附属北京安定医院及北京市朝阳区第三医院的住院及门诊精神分裂症患者为研究对象，共纳入53例患者，脱落3例，剩余50例根据阳性与阴性症状量表评分，分为低频（1Hz）治疗组26例和高频（10 Hz）治疗组24例，各治疗组再采用数字表法随机分为实验组和对照组。本研究为随机双盲对照研究，对照组进行伪刺激，评估两组精神分裂症患者的临床症状，将两组的治疗效果进行比较。结果 共收集符合入组标准患者53例，共有50例完成研究。经t检验和χ²检验，两组间的基本资料差异均无统计学意义。低频治疗：组间差异均无统计学意义，但在时间上差异存在统计学意义，第4周末的量表评分明显降低。高频治疗：组间差异均无统计学意义，阴性因子分、精神病理分、一般精神病理分在时间上差异有统计学意义，第4周末的量表评分明显降低。治疗过程中有3例1Hz实验组患者和2例10 Hz实验组患者诉第1次治疗时感头痛、麻木感，余无不适主诉。结论 尚未发现重复经颅磁刺激合并药物治疗对难治性精神分裂症患者的阳性症状及阴性症状有影响。

Augmentation of rTMS in the treatment of refractory schizophrenia

Objective To explore the augmentation effect of repetitive transcranial magnetic stimulation in the treatment of refractory schizophrenia.Method< Fifty schizophrenia patients were included and were divided into low frequency (1Hz) treatment group of 26 cases and high frequency (10 Hz) treatment group of 24 cases. Each treatment group was further randomly divided into an experimental group and a control group. This study is a randomized, double-blind, controlled study, the control group was subjected to pseudo-stimulation. The clinical symptoms of the two groups of patients were evaluated and the therapeutic effects of the two groups were compared.Results A total of 53 patients who met the inclusion criteria were enrolled, and a total of 50 patients completed the study.After t test and χ² test, there was no significant difference in the basic data between the two groups.Low frequency treatment:there was no statistically significant difference between the groups. High frequency treatment:There was no statistically significant difference between the groups There was a time difference in the scale scores for the 4th weekend for all patients in the group. High frequency treatment:There was no statistically significant difference between the groups, Three patients with 1Hz experimental group and two patients with 10 Hz experimental group complained of headache and numbness during the first treatment, other patients are not uncomfortable.Conclusion Repetitive transcranial magnetic stimulation combined with drug therapy has not been found to have an effect on positive and negative symptoms in patients with refractory schizophrenia.