重复经颅磁刺激对首发精神分裂症患者认知功能和社会功能的影响

申变红; 汪程鹏; 张开元; 高可润; 张智雯; 朱春燕; 方玲; 汤剑平

doi:10.16766/j.cnki.issn.1674-4152.003384

重复经颅磁刺激对首发精神分裂症患者认知功能和社会功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.003384

浙江大学医学院附属精神卫生中心杭州市第七人民医院精神科，浙江杭州 310013

基金项目:

浙江省医药卫生科技计划项目 2019RC073

详细信息

通讯作者:
申变红，E-mail：bhsh0513005@126.com

中图分类号: R749.05 R454.1
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出版历程
- 收稿日期: 2023-04-23
- 网络出版日期: 2024-03-27

Effects of repeated transcranial magnetic stimulation on cognitive and social function in patients with first-episode schizophrenia

Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang 310013, China

摘要

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(χ²=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。
- 精神分裂症 /
- 重复经颅磁刺激 /
- 认知功能 /
- 社会功能
Abstract: Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on cognitive and social function in patients with first-episode schizophrenia, and to provide evidence for clinical treatment. Methods A total 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 battery 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 observation 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), χ²=0.202, P=0.653. Conclusion rTMS can effectively improve cognitive and social function in patients with first-episode schizophrenia, and has high safety.
- Schizophrenia /
- Repeated transcranial magnetic stimulation /
- Cognitive function /
- Social function

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表 1 2组首发精神分裂症患者治疗前后RBANS评分比较(x±s，分)

Table 1. Comparison of RBANS scores before and after treatment in two groups of first-episode schizophrenia patients (x±s, points)

组别	例数	即刻记忆		延时记忆		言语功能
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	26.28±1.69	45.69±2.31^a	29.71±2.12	46.79±3.15^a	23.98±2.76	33.87±2.25^a
对照组	48	25.96±1.66	38.62±1.29^a	29.85±2.19	42.65±3.78^a	23.82±2.25	27.75±2.91^a
t值		0.936	18.513	-0.318	5.829	0.311	11.527
P值		0.352	＜0.001	0.751	＜0.001	0.756	＜0.001

组别	例数	视觉空间结构		注意力		RBANS总分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	25.71±2.81	35.81±2.91^a	28.97±2.82	53.75±3.82^a	133.85±5.92	237.75±9.79^a
对照组	48	25.73±2.72	28.62±2.79^a	29.27±2.86	48.85±3.95^a	132.76±5.87	203.96±9.89^a
t值		-0.035	12.356	-0.517	6.178	0.906	16.823
P值		0.972	＜0.001	0.606	＜0.001	0.367	＜0.001
注：与同组治疗前比较，^a P＜0.05。

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表 2 2组首发精神分裂症患者治疗前后SSPI评分比较(x±s，分)

Table 2. Comparison of SSPI scores before and after treatment in two groups of first-episode schizophrenia patients (x±s, points)

组别	例数	日常生活能力		社会性活动技能		动性和交往情况		SSPI总分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	5.15±0.35	7.84±0.63^a	7.92±0.16	11.76±1.73^a	8.75±0.92	12.72±1.52^a	21.67±1.92	32.95±1.87^a
对照组	48	5.12±0.83	6.58±0.31^a	7.89±0.26	9.82±1.79^a	8.62±0.97	10.58±1.42^a	21.82±1.87	28.89±1.98^a
t值		0.231	12.433	0.681	5.399	0.674	7.128	-0.388	10.328
P值		0.818	＜0.001	0.498	＜0.001	0.502	＜0.001	0.699	＜0.001
注：与同组治疗前比较，^a P＜0.05。

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表 3 2组首发精神分裂症患者治疗后不良反应比较[例(%)]

Table 3. Comparison of adverse reactions after treatment in two groups of first-episode schizophrenia [cases (%)]

组别	例数	口干	恶心	失眠	便秘	合计
观察组	48	2(4.17)	4(8.33)	5(10.42)	4(8.33)	15(31.25)
对照组	48	4(8.33)	2(4.17)	3(6.25)	4(8.33)	13(27.08)
注：2组不良反应总发生率比较，χ²=0.202，P=0.653。

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