重复经颅磁刺激治疗精神分裂症顽固性幻听的效果研究

目的探究并分析低频重复经颅磁刺激（rTMS）合并利培酮治疗精神分裂症顽固性幻听的疗效及其安全性。方法选择2010年12月～2012年12月杭州市第七人民医院住院治疗的精神分裂症患者90例为研究对象。应用随机数字表法将精神分裂症患者分为3组，每组各30例。观察组给予利培酮和rTMS治疗，对照组1给予利培酮和伪rTMS治疗，对照组2则给予维持原治疗剂量利培酮治疗，持续2周时间。在治疗前、治疗2周和治疗后3个月后进行大体评定量表（GAS）、听幻觉量表（AHRS）和副反应量表（TESS）的评定，比较3组患者临床疗效及其安全性。结果治疗2周和治疗后3个月对照组1幻听评分高于对照组2，但差异无统计学意义（P〉0．05），观察组幻听评分低于对照组2和对照组1，差异有统计学意义（尸〈0．05）。治疗2周和治疗后3个月观察组大体评定量表得分高于对照组2和对照组1．差异有统计学意义（P〈0．05）。观察组有4例患者，对照组1有2例患者，对照组2有3例患者出现头痛，差异无统计学意义（X。=0．797，P〉0．05）。结论1Hz低频rTMS用于精神分裂症双背侧前额叶能够显著改善精神分裂症患者顽固性幻听症状，具有安全高效等特点。

Effect research on refractory auditory hallucination of schizophrenia by repetitive transcranial magnetic stimulation

Objective To explore the effects and its safety of refractory auditory hallucination of schizophrenia by slow repetitive transeranial magnetic stimulation and combined risperidone. Methods 90 schizophrenic patients treated in the Seventh People＇s Hospital of Hangzhou City from December 2010 to December 2012 were chosen as the research objects, they were divided into 3 groups with 30 cases in each group. The observation group was given risperidone and rTMS treatment, the control group 1 was given risperidone and pseudo rTMS treatment, the control group 2 was treated with the original dose risperi- done treatment, all patients were treated for 2 weeks. Global assessment scale （GAS）, auditory hallucination rating scale （AHRS） and treatment emergent symptom scale （TESS） were assessed before treatment, after 2 weeks and 3 months. The effects and its safety of schizophrenia patients were compare. Results The scores of AHRS in the control group 1 were higher than that in the control group 2 after 2 weeks and 3 months, the difference was not statistically significant （P 〉 0.05）; the scores of AHRS in observation group were higher than those in other groups after 2 weeks and 3 months, the differences were statistically significant （P 〈 0.05）. The scores of GAS in the control group 1 were higher than that in control group 2 after 2 weeks and 3 months, the differences were statistically significant （P 〈 0.05）. 4 cases with headache in observation group, 2 cases with headache in control group 1, 3 cases with headache in control group 2 were found, the difference was not statistically significant （X2 = 0.797, P 〉 0.05）. Conclusion Effect on refractory auditory hallucination of double dorsal prefrontal cortex in schizophrenia by 1 Hz repetitive transcranial magnetic stimulation can significantly improve the refractory auditory hallucination of schizophrenia patients, it is safe and efficient.