无抽搐电休克与药物治疗毒品所致精神障碍疗效对照研究

目的比较无抽搐电休克与药物治疗毒品所致精神障碍疗效及安全性。方法200例毒品所致精神障碍患者随机分为两组,分别用无抽搐电休克和常规精神药物治疗,疗程均为4周。采用阳性和阴性症状量表(PANSS)、临床疗效总评量表(CGI)及治疗中需处理的不良反应量表(TESS)于治疗前和治疗后第一、二、四周末分别评定疗效和副反应。结果无抽搐电休克组治疗第一周末和第二周末PANSS总分减分率显著高于药物组(t=20.03,P<0.001)。治疗第一周末和第二周末无抽搐电休克组的疗效就显著优于药物组(χ2=139.43,P<0.001)、(χ2=151.54,P<0.001),治疗第一周末无抽搐电休克组显效率为51%,而药物组显效率为0%;治疗第二周末无抽搐电休克组显效率为99%,而药物组显效率为13%;第四周末两组总体疗效的差异也有统计学意义(χ2=24.61,P<0.001)。TESS评定,两组间的不良反应发生率的差异有非常显著统计学意义(χ2=187.41,P<0.001)。结论无抽搐电休克组的疗效显著优于药物组,其独特的优势是起效迅速、副反应少、疗效确切、依从性高、安全可靠,尤其适合长期吸毒的慢性患者治疗。

Control study on effect of MECT and pharmacotherapy on drug-induced mental disorders

OBJECTIVE To compare the clinical effect of MECT and pharmacotherapy on drug-induced mental disorders and its safety.METHODS 200 cases patients drug-induced mental disorders are randomly divided into two groups,on which MECT and conventional psychotropic drug are adopted respectively,and the course of treatment is 4 weeks.Evaluate respectively the effect and side reaction in the first,second,and fourth week before and after the treatment with the Positive and Negative Syndrome Scale（PANSS）,the Clinical Global Impression（CGI） and adverse effect occurring in the treatment that need to handle with Treatment Emergent Symptom Scale（TESS）.RESULTS The PANSS total score deduction rate of MECT treatment group is significantly higher than the conventional drug group at the end of the first and the second week（t=20.03,P〈0.001）.The effect of non-twitch electric shock group is remarkably superior to the drug group at the end of the first and the second week（χ2=139.43,P〈0.001）,（χ2=151.54,P〈0.001）.The clinical effectual rate of non-twitch electric shock group is 51% at the end of the first week,and that of the drug group is 0%;the clinical effectual rate of non-twitch electric shock group is 99% at the end of the second week,and that of the drug group is 13%;the difference of the two groups of overall effect at the end of the fourth week also has statistical significance（χ2=24.61,P〈0.001）.As assessed by TESS,the difference between the two groups of adverse reaction rate has a rather notable statistical significance（χ2=187.41,P〈0.001）.CONCLUSION The curative effect of non-twitch electric shock group is remarkable superior to the drug group.And its unique advantage is fast effect,less side effect,accurate curative effect,high compliance and security,especially suitable for the treatment of long-term drug chronic patients.