摘要
目的 探讨重复经颅磁刺激(rTMS)对首发精神分裂症患者认知和社会功能的改善效果,为临床治疗提供依据.方法 选取杭州市第七人民医院2019年2月-2022年2月收治的精神分裂症患者96例,采用随机数字表法分为观察组(采用rTMS真刺激)和对照组(行伪刺激),各48例,比较2组治疗前后认知功能[重复性成套神经心理状态量表(RBANS)]、社会功能[住院精神病患者社会功能评定量表(SSPI)]评分及不良反应发生情况.结果 治疗1个月后,观察组RBANS量表中即刻记忆、延时记忆、言语功能、视觉空间结构、注意力及RBANS总分分别为(45.69±2.31)分、(46.79±3.15)分、(33.87±2.25)分、(35.81±2.91)分、(53.75±3.82)分、(237.75± 9.79)分,对照组分别为(38.62±1.29)分、(42.65±3.78)分、(27.75±2.91)分、(28.62±2.79)分、(48.85±3.95)分、(203.96±9.89)分;观察组SSPI量表中日常生活能力、社会性活动技能、动性和交往情况、SSPI总分分别为(7.84±0.63)分、(11.76±1.73)分、(12.72±1.52)分、(32.95±1.87)分,对照组分别为(6.58±0.31)分、(9.82± 1.79)分、(10.58±1.42)分、(28.89±1.98)分,观察组RBANS和SSPI量表评分均明显高于对照组(P<0.05).观察组不良反应总发生率(31.25%,15/48)与对照组(27.08%,13/48)比较差异无统计学意义(x2=0.202,P=0.653).结论 rTMS能有效改善首发精神分裂症患者的认知和社会功能,具有较高的安全性.
Abstract
Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on cognitive and so-cial function in patients with first-episode schizophrenia,and to provide evidence for clinical treatment.Methods A to-tal of 96 patients with schizophrenia admitted to Hangzhou Seventh People's Hospital from February 2019 to February 2022 they were used the random number table method to randomly divide 48 cases into the observation group(with rTMS true stimulation)and the control group(with pseudo-stimulation),and the scores of cognitive functions[repeatable bat-tery for the assessment of neuropsychological status(RBANS)]and social function[scale of social function in psychosis inpatients(SSPI)]and adverse reactions before and after treatment were compared between the two groups.Results After one month of treatment,immediate memory,delayed memory,speech function,visuospatial structure,attention and total scores of RBANS in observation group were(45.69±2.31),(46.79±3.15),(33.87±2.25),(35.81±2.91),(53.75±3.82),and(237.75±9.7)points,respectively,and in the control group were(38.62±1.29),(42.65± 3.78),(27.75±2.91),(28.62±2.79),(48.85±3.95),(203.96±9.89)points,respectively.The SSPI scale scores of daily living skills,social and sexual activity skills,mobility and interaction,and total SSPI scores in the obser-vation group were(7.84±0.63),(11.76±1.73),(12.72±1.52),and(32.95±1.87)points,respectively,and in the control group were(6.58±0.31),(9.82±1.79),(10.58±1.42),(28.89±1.98)points,respectively.The scores of RBANS and SSPI in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in adverse reactions between the observation group(31.25%,15/48)and the control group(27.08%,13/48),X2=0.202,P=0.653.Conclusion rTMS can effectively improve cognitive and social func-tion in patients with first-episode schizophrenia,and has high safety.