上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (2): 177-.doi: 10.3969/j.issn.1674-8115.2013.02.010

• 论著（临床研究） • 上一篇    下一篇

低频重复经颅磁刺激治疗老年精神分裂症患者顽固性幻听的疗效及安全性研究

岳 玲, 李冠军, 王继军, 王静华   

  1. 上海交通大学 医学院附属精神卫生中心, 上海 200030
  • 出版日期:2013-02-28 发布日期:2013-03-07
  • 通讯作者: 李冠军, 电子信箱: liguanjun66@126.com。
  • 作者简介:岳 玲（1981—）, 女, 硕士生；电子信箱: bellinthemoon@hotmail.com。
  • 基金资助:

    上海市精神卫生中心科研基金（2010-YJ-15），国家临床重点专科-上海市精神卫生中心（卫生部医政司2011-873）

Efficacy and safety of slow repetitive transcranial magnetive stimulation in treatment of resistant auditory hallucination in elderly patients with schizophrenia

YUE Ling, LI Guan-jun, WANG Ji-jun, WANG Jing-hua   

  1. Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
  • Online:2013-02-28 Published:2013-03-07
  • Supported by:

    Shanghai Mental Health Center Foundation, 2010-YJ-15； National Key Clinical Disciplines at Shanghai Mental Health Center, Office of Medical Affairs, the Ministry of Health of China, 2011-873

PDF (PC)

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摘要：

目的 探讨低频重复经颅磁刺激（rTMS）对老年精神分裂症患者顽固性幻听的疗效和安全性。方法 以20例精神分裂症伴顽固性幻听病程≥1年的老年患者为研究对象，在原有抗精神病药物种类及剂量不变的情况下给予经左侧颞顶叶低频(1 Hz) rTMS，每周rTMS治疗5次，连续2周。比较治疗前后阳性和阴性症状量表(PANSS)、简易智力状态检查(MMSE)、临床疗效总印象表（CGI)评分；以治疗后幻听评分减分≥2分为有效，<2分为无效。治疗2周后对患者进行rTMS治疗接受程度问卷调查。结果 7例患者rTMS治疗幻听有效，13例无效。CGI疗效指数评分显示总有效率为45.0%。所有患者均能接受rTMS治疗过程，无严重不良事件发生。结论 低频rTMS治疗老年精神分裂症患者顽固性幻听症状具有较好的疗效和安全性。

关键词: 重复经颅磁刺激, 幻听, 老年, 精神分裂症

Abstract:

Objective To investigate the efficacy and safety of slow repetitive transcranial magnetive stimulation (rTMS) in the treatment of resistant auditory hallucination in elderly patients with schizophrenia. Methods Twenty elderly patients with schizophrenia and duration of resistant auditory hallucination no less than one year were selected. On the basis of stable antipsychotic drugs treatment, patients underwent slow rTMS (1 Hz) therapy in left temporoparietal region in two weeks, with 5 times per week. The scores of Positive and Negative Syndrome Scale (PANSS), MiniMental State Examination (MMSE) and Clinical Global Impression Scale (CGI) before and after treatment were compared. The decrease in score of auditory hallucination for no less than 2 points was defined as effectiveness, and that for less than 2 points was considered as ineffectiveness. The acceptance of rTMS by patients were surveyed with questionnaire 2 weeks after treatment. Results Effectiveness of rTMS therapy in treatment of auditory hallucination was achieved in 7 patients, and ineffectiveness in 13 patients. The total efficiency rate was 45.0% revealed by CGI scoring. All subjects accepted rTMS therapy, and no adverse event occurred. Conclusion It is effective and safe for slow rTMS to treat elderly patients with schizophrenia and resistant auditory hallucination.

Key words: repetitive transcranial magnetic stimulation, auditory hallucination, elderly, schizophrenia