上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (1): 81-.doi: 10.3969/j.issn.1674-8115.2020.01.013

• 论著·临床研究 • 上一篇    下一篇

重复经颅磁刺激对精神分裂症疗效及安全性研究的meta分析

黄 燕1，张宪高2，林 亨1，程淑英1   

  1. 1. 华北理工大学心理学院精神医学系，唐山 063210；2.华北理工大学附属医院，唐山 063000
  • 出版日期:2020-01-28 发布日期:2020-03-05
  • 通讯作者: 程淑英，电子信箱：csy3726560@163.com。
  • 作者简介:黄 燕（1994—），女，硕士生；电子信箱：1477823579@qq.com。

Meta-analysis of effect and safety of repetitive transcranial magnetic stimulation on patients with schizophrenia

HUANG Yan, ZHANG Xian-gao, LIN Heng, CHENG Shu-ying   

  1. 1. Department of Psychiatry, North China University of Technology, Tangshan 063210, China; 2.Affiliated Hospital of North China University of Technology, Tangshan 063000, China
  • Online:2020-01-28 Published:2020-03-05

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摘要： 目的·采用meta分析评价重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）对精神分裂症的疗效及安全性，为临床治疗精神分裂症提供证据支持。方法·电子检索rTMS与精神分裂症相关的随机对照研究(randomized controlled trial，RCTs)，检索数据库包括Embase、PubMed、Cochrane Library、CNKI、万方和维普期刊数据库，控制纳入的文献质量，采用软件Stata 15.1进行分析。结果·共计纳入17个RCTs，涉及刺激组486例，对照组436例。rTMS对精神分裂症患者治疗有效（OR3.32，95% CI 1.93～5.70，Z4.35，P0.000）；rTMS治疗对精神分裂症患者整体情况、阴性症状有效（SMD-0.33，95%CI -0.58～-0.08，Z2.61，P0.009；SMD-0.41，95% CI -0.65～-0.17，Z3.31，P0.001），对阳性症状无效（P0.755）；2组不良反应的差异无统计学意义（P0.732)；亚组分析结果显示，高频（10 Hz）刺激、治疗4周才起到治疗效果。结论·rTMS治疗精神分裂症阴性症状作用显著，但对阳性症状无效，安全性较高。

关键词: 精神分裂症, 重复经颅磁刺激, meta分析

Abstract:

Objective · To evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) for schizophreniameta-analysis, and provid evidence support for clinical treatment of schizophrenia. Methods · Randomized controlled trials of rTMS and schizophrenia were searched on Embase, PubMed, Cochrane Library, CNKI, Wanfang and VIP. The quality of the included literature was controlled and meta-analysis was performed with Stata 15.1 software. Results · Seventeen studies were enrolled, including 486 patients in the stimulation group and 436 in the control group. rTMS was effective in treating patients with schizophrenia (OR3.32, 95% CI 1.93—5.70, Z4.35, P0.000); rTMS treatment was effective for overall condition and negative symptoms of patients with schizophrenia (SMD-0.33, 95% CI -0.58—-0.08, Z2.61, P0.009; SMD-0.41, 95% CI -0.65—-0.17, Z3.31, P0.001), and ineffective for positive symptoms (P0.755). There was no significant difference in adverse reactions between the two groups (P0.732). Subgroup analysis revealed that only high frequency (10 Hz) stimulation and treatment for 4 weeks could achieve therapeutic effects. Conclusion · rTMS is effective in treating negative symptoms of patients with schizophrenia and has high therapeutic safety, but it is ineffective for positive symptoms.

Key words: schizophrenia, repetitive transcranial magnetic stimulation(rTMS), meta-analysis