重复经颅磁刺激联合舒必利治疗以阴性症状为主的精神分裂症疗效

目的：研究重复经颅磁刺激（rTMS）联合舒必利治疗精神分裂症阴性症状的疗效，观察其安全性与不良反应。方法：68例住院精神分裂症患者随机分为真刺激组（n=34）和伪刺激组（13=34），真刺激组采用重复经颅磁刺激结合舒必利治疗，伪刺激组给予假性刺激结合舒必利治疗。治疗前、治疗1周、2周、4周及6周应用阳性和阴性症状量表（PANSS）评定疗效，采用不良反应量表（TESS）、体格检查、实验室检查及心电图评定药物的安全性。结果：两组治疗前后总显效率有显著性差异（P〈0．05）。PANSS量表评分具有显著性差异，真刺激组疗效明显优于伪刺激组（P〈0．01）。真刺激组与伪刺激组治疗中均无严重不良反应，不良反应差异无统计学意义。结论：重复经颅磁刺激联合舒必利治疗精神分裂症阴性症状较单纯舒必利治疗疗效显著，起效快，不良反应少，值得临床加以推广并深入研究。

Curative effects of repetitive Transcranial Magnetic Stimulation (rTMS)combined with sulpiride in treatment of schizophrenia with predominantly negative symptoms

Objective： To explore curative effects of repetitive transcranial magnetic stimulation （rTMS） combined with sulpiride in treatment of schizophrenia with predominantly negative symptoms and observe its safety and adverse reactions. Methods ：64 schizophrenic patients with predominantly negative symptoms were randomly divided into real rTMS treatment group （ n = 33 ） or sham rTMS treatment group （n = 31 ）. The cases in real rTMS treatment group were treated by rTMS and sulpiride, whereas those in sham rTMS treatment group were given sham stimulation and sulpiride. The curative effects were assessed by positive and negative syndrome score （PANSS）, the adverse reactions were evaluated by treatment emergent symptom scale （TESS）, and drug safety was assessed by physical examination, laboratory examination and electrocardiogram before and 1, 2, 4, and 6 weeks after the treatment. Results： Differences of the total notably effective rates between the two groups was significant （P 〈 0.05）, and that of PANSS scores was also significant （P 〈 0.01 ）. The curative effects of real rTMS treatment group was better than that of sham rTMS treatment group. Therewere no severe adverse reactions in the two groups, and the differences were not statistically significant. Conclusions： rTMS combined with sulpiride in treatment of schizophrenia patients with negative symptoms has the advantages of obvious curative effects, rapid onset and a few adverse reactions, can increase the compliance, and is worth being used in the clinical field and further studied.