低频重复经颅磁刺激与无抽搐电休克治疗精神分裂症患者的疗效及白质完整性分析

发布时间：2018-10-20 15:07

【摘要】：目的探索低频重复经颅磁刺激(r TMS)与无抽搐电休克(MECT)对精神分裂症患者的疗效及白质完整性分析。方法选取2015年5月至2016年10月于我院收治的精神分裂患者120例,随机分为MECT组(60例)和r TMS组(60例),分别给予无抽搐电休克治疗8次和重复经颅磁刺激治疗12次。采用PANSS评定临床疗效;RBANS评价认知功能;TESS评定不良反应;通过FA值评估白质结构完整性。结果治疗后MECT组与r TMS组PANSS评分较治疗前均显著下降,差异具有统计学意义(P0.05),两组治疗前及治疗后PANSS评分差异均无统计学意义(P0.05)。治疗后MECT组与r TMS组RBANS评分较治疗前均显著升高,差异具有统计学意义(P0.05),两组治疗前及治疗后RBANS评分差异均无统计学意义(P0.05)。两组患者治疗前TESS评分差异无统计学意义(P0.05),治疗后MECT组TESS评分高于r TMS组,差异具有统计学意义(P0.05)。治疗后MECT组与r TMS组左侧扣带回前部、左侧扣带回后部、左侧前额叶以及胼胝体膝部较治疗前FA值都有所升高,差异有统计学意义(P0.05)。r TMS组较MECT组治疗后各脑区FA值增幅大,差异有统计学意义(P0.05)。结论 MECT及r TMS均具有显著的临床疗效,可提高精神分裂症患者的认知功能,且r TMS较MECT更为安全,对阻止白质完整性损害的作用较MECT强。
[Abstract]:Objective to investigate the efficacy and white matter integrity of low frequency repetitive transcranial magnetic stimulation (r TMS) and no convulsive electroshock (MECT) in patients with schizophrenia. Methods 120 schizophrenic patients admitted in our hospital from May 2015 to October 2016 were randomly divided into two groups: MECT group (n = 60) and r TMS group (n = 60). They were treated with no convulsive electroshock for 8 times and repeated transcranial magnetic stimulation for 12 times respectively. PANSS was used to evaluate clinical efficacy, RBANS to evaluate cognitive function, TESS to evaluate adverse reactions, and FA to evaluate the structural integrity of white matter. Results after treatment, the PANSS scores of MECT group and r TMS group were significantly lower than those of before treatment (P0.05), and there was no significant difference in PANSS score between the two groups before and after treatment (P0.05). The RBANS scores in MECT group and r TMS group were significantly higher than those before treatment (P0.05). There was no significant difference in RBANS score between the two groups before and after treatment (P0.05). There was no significant difference in TESS score between the two groups before treatment (P0.05). The TESS score of MECT group was higher than that of r TMS group after treatment (P0.05). After treatment, the FA values of left cingulate gyrus, posterior cingulate gyrus, left prefrontal lobe and genu of corpus callosum in MECT group and r TMS group were higher than those before treatment. The difference was statistically significant (P0.05). The difference was statistically significant (P0.05). Conclusion both MECT and r TMS have significant clinical effects and can improve cognitive function of schizophrenic patients. R TMS is more safe than MECT and can prevent the damage of white matter integrity more effectively than MECT.
【作者单位】：西南医科大学附属医院精神科;成都市第四人民医院精神科;
【分类号】：R749.3

【相似文献】