重复经颅磁刺激联合奥氮平治疗急性期精神分裂症幻听的疗效及安全性研究

摘要

Objective:The efficacy and safety study to acute schizophrenia with auditory hallucination by repetitive transcranial mag-netic stimulation ( rTMS) with olanzapine therapy.Methods:80 schizophrenia with auditory hallucination were randomly divided into treatment group (40 cases) and control group (40 cases) .Treatment group given 1 hz rTMS stimulation ten times, 20 minutes every time. but no rTMS stimulation to control group.At the same time the two groups were given olanzapine treatment for 14 days.By using positive and negative symptoms scale ( PANSS) , auditory hallucinations scale ( AHRS) and the clinical global impression scale( CGI) to evaluate the therapeutic effect.Treatment emergent symptoms scale( TESS) to assess the side effects.Results:37 cases of treatment group com-plete the study, 36 cases of control group complete the study.At the end of the study, P3(hallucinatory behavior) score from PANSS in treatment group and the AHRS score were lower than the control group (t =5.85, 5.10;P 0.05).there was no statistically significant difference to TESS in two groups (c2 =0.34, P =0.34), there were no serious adverse reactions.Conclusion:there are obvious curative effect and good safety to schizophrenia with auditory hallucination by Olanzapine combine low frequency rTMS.%目的：探讨重复经颅磁刺激（ rTMS）联合奥氮平治疗急性期精神分裂症幻听的疗效及安全性。方法：80例精神分裂症有幻听患者随机分为rTMS治疗组（40例）和对照组（40例）。治疗组给予10次1Hz rTMS刺激治疗，每次20分钟。2组同时给予奥氮平治疗14天。采用阳性与阴性症状量表（ Positive and Negative Syndrome Scale，PANSS）、听幻觉量表（ Auditory Hallucina-tions Rating Scale，AHRS）及临床疗效总评量表（Clinical Global Impression Scale，CGI）评定治疗效果。副反应量表（Treatment E-mergent Symptoms Scale，TESS）评定其副反应。结果：80例患者中，治疗组完成37例，对照组完成36例。研究结束时治疗组PAN-SS P3评分及AHRS评分均低于对照组（t＝5．85，5．10；P＜0．05），但2组PANSS总分及CGI－SI评分差异无统计学意义（t＝1．25，1．56；P＞0．05）。2组不良反应（TESS）差异无统计学意义（x2＝0．34，P＝0．562），均无严重不良反应出现。结论：奥氮平联合低频rTMS治疗精神分裂症的幻听症状疗效明显，且安全性好。