土文珍,林小东,陈策,等.重复经颅磁刺激治疗慢性精神分裂症阴性症状的疗效研究[J].中华物理医学与康复杂志,2019,41(3):202-205
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| 重复经颅磁刺激治疗慢性精神分裂症阴性症状的疗效研究 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.03.009 |
| 中文关键词: 精神分裂症 重复经颅磁刺激 阴性症状 |
| 英文关键词: Schizophrenia Transcranial magnetic stimulation Event-related potentials |
| 基金项目:国家自然科学基金项目（81471357）；温州市科技局基金项目（Y 20160257） |
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| 中文摘要: |
| 目的 探讨重复经颅磁刺激(rTMS)对慢性精神分裂症患者阴性症状和对事件相关脑电位P300的康复治疗效果。 方法 选取康复期慢性精神分裂症患者90例，随机分为5 Hz组、10 Hz组和15 Hz组，每组患者30例。3组患者分别给予对应的5 Hz、10 Hz和15 Hz的rTMS治疗，每日治疗1次，每周治疗5次，连续治疗5周（即25次）。3组患者均于治疗前和疗程结束后（治疗后）采用P300进行检测，并采用阴性症状量表（SANS）量表评估疗效。 结果 治疗后，10 Hz组患者的SANS评分与组内治疗前和其余2组治疗后比较，差异均有统计学意义（P<0.05）。治疗后，10 Hz组患者P300的波幅与组内治疗前比较，差异有统计学意义（P<0.05）。多元逐步回归，得出患者的年龄和病程进入最终的方程，而性别、受教育年限和药物治疗剂量被剔除出回归方程，即慢性精神分裂症患者的年龄越大、病程越长，其rTMS治疗后阴性症状的改善幅度越小。 结论 与5 Hz和15 Hz的rTMS治疗相比，10 Hz的rTMS治疗可更有效地改善慢性精神分裂症的阴性症状和认知功能。 |
| 英文摘要: |
| Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the negative symptoms of chronic schizophrenia and on the P300 component of schizophrenics′ event-related potentials (ERPs). Methods Ninety convalescing schizophrenia patients were randomly divided into a 5 Hz group, a 10 Hz group and a 15 Hz group, each of 30. The three groups were treated with the corresponding 5 Hz, 10 Hz or 15 Hz rTMS once a day, five times a week for five consecutive weeks. The P300 ERPs of all three groups were tested before and after the treatment. Any curative effect was evaluated using the scale for the assessment of negative symptoms (SANS). Results After the treatment, the average SANS score of the 10 Hz group was significantly different from that before the treatment and also from those of the other two groups after the treatment. After the treatment, significant improvement was also observed in the amplitude of P300 in the 10 Hz group. The treatment′s effectiveness was negatively correlated with age and longer course of the disease. Conclusion rTMS at 10 Hz is the most effective of the protocols tested for improving the negative symptoms of schizophrenia and improving cognitive functioning. |
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