奥氮平联合重复经颅磁刺激或改良电休克治疗精神分裂症的疗效分析

目的:比较抗精神病药物奥氮平联合复经颅磁刺激(rTMS)或改良电休克(MECT)治疗精神分裂症的疗效。方法:将84例精神分裂症患者随机分为rTMS组(42例)与MECT组(42例),两组分别在奥氮平的基础上联合MECT或rTMS进行治疗。在治疗2、4、8周末后,采用阳性症状和阴性症状量表PANSS、治疗时出现症状量表TESS评估临床治疗效果及不良反应,同时采用修订韦氏记忆量表(WMS-RC)和威斯康星卡片分类测验(WCST)评定认知功能。结果:治疗后,两组总有效率比较无统计学差异(P0.05)。两组治疗后PANSS总分、阳性症状、阴性症状和一般病理分值均显著低于治疗前(P0.05,P0.01),但组间比较无统计学差异(P0.05)。两组TESS评分及不良反应的发生情况比较无统计学差异(P0.05)。与治疗前相比,两组患者治疗后认知功能均显著改善(P0.05,P0.01),且rTMS联合组在改善患者记忆功能、执行能力方面效果优于MTCT组(P0.05)。结论:奥氮平联合MECT或rTMS对精神分裂症状的疗效相当,但联合rTMS可更显著改善患者的认知功能。

Effects of Olanzapine Combined with Repetitive Transcranial Magnetic Stimulation or Modified Electric Convulsive Therapy on Schizophrenia

Objective:To compare the effects of olanzapine combined with repetitive transcranial magnetic stimulation (rTMS) or modified electric convulsive (MECT) therapy on schizophrenia.Methods:A total of 84 cases of patients with schizophrenia were collected and divided into the olanzapine plus MECT (n=42) and the olanzapine plusrTMS group (n=42). The positive and negative symptom scale (PANSS) was used to evaluate the efficacy at the end of 2nd, 4th and 8th week after treatment. The adverse reactions Scale (TESS) was introduced to evaluate the adverse reactions. The cognitive function was evaluated with Weschler Memory Scale (WMS) and Wisconsin Card Test (WCST).Results:There was no significant difference in the total effective rate, total score of PANSS, positive symptoms, negative symptoms and general pathological symptoms betwwen MECT and rTMS group (P>0.05). But the total score of PANSS, positive symptoms, negative symptoms and general pathological symptoms were significantly decreased (P<0.05, P<0.01) after treatment. There was no significant difference in the incidence of adverse reactions between rTMS and MECT group (P>0.05). However, the cognition was obviously ameliorated following treatment with olanzapine plus rTMS or MECT (P<0.05, P<0.01). and higher improvement in memory and execution capacity was observed in olanzapine plus rTMS groups, when compared with olanzapine plus MECT group (P<0.05).Conclusion:The combined application of olanzapine with rTMS or MECT had the similar efficacy in the treatment of schizophrenia, but the former exhibited the higher therapeutic effect on the improvement of cognitive function.