临床精神医学杂志
臨床精神醫學雜誌
림상정신의학잡지
JOURNAL OF CLINICAL PSYCHOLOGICAL MEDICINE
2015年
4期
241-243
,共3页
樊园媛%涂哲明%张新风%肖寒
樊園媛%塗哲明%張新風%肖寒
번완원%도철명%장신풍%초한
重复经颅磁刺激%精神分裂症%戒烟
重複經顱磁刺激%精神分裂癥%戒煙
중복경로자자격%정신분렬증%계연
repetitive transcranial magnetic simulation%schizophrenia%smoking cessation
目的：探讨重复经颅磁刺激（rTMS）对门诊精神分裂症患者戒烟的疗效及安全性。方法：55例门诊精神分裂症合并烟草依赖患者随机分为 rTMS 组（28例）和伪 rTMS 组（27例），分别接受右侧背外侧前额叶皮质 rTMS 刺激（10Hz，100%运动阈值）和伪刺激，疗程4周。入组时和治疗第 l、2、4、8周末进行临床评估，以日均吸烟量、尼古丁依赖量表（FTND）评分、呼气末 CO 值及戒烟率评定疗效，以阳性及阴性症状量表（PANSS）、不良反应评定安全性。结果：日均吸烟量、FTND 评分和呼气末 CO值具有组别主效应（F ＝65.33，F ＝25.86，F ＝38.19）和时间主效应（F ＝24.66；F ＝29.92；F ＝18.92）（P ﹤0.05或 P ﹤0.01）；日均吸烟量具有交互作用（F ＝5.11，P ﹤0.05）；治疗第4周末 rTMS 组戒烟率（32.1%）高于伪 rTMS 组（7.4%，P ﹤0.05）；治疗前后两组 PANSS 评分及头痛发生率差异无统计学意义。结论：rTMS 能减少精神分裂症患者的日均吸烟量和尼古丁依赖程度、提高戒烟率，安全性好。
目的：探討重複經顱磁刺激（rTMS）對門診精神分裂癥患者戒煙的療效及安全性。方法：55例門診精神分裂癥閤併煙草依賴患者隨機分為 rTMS 組（28例）和偽 rTMS 組（27例），分彆接受右側揹外側前額葉皮質 rTMS 刺激（10Hz，100%運動閾值）和偽刺激，療程4週。入組時和治療第 l、2、4、8週末進行臨床評估，以日均吸煙量、尼古丁依賴量錶（FTND）評分、呼氣末 CO 值及戒煙率評定療效，以暘性及陰性癥狀量錶（PANSS）、不良反應評定安全性。結果：日均吸煙量、FTND 評分和呼氣末 CO值具有組彆主效應（F ＝65.33，F ＝25.86，F ＝38.19）和時間主效應（F ＝24.66；F ＝29.92；F ＝18.92）（P ﹤0.05或 P ﹤0.01）；日均吸煙量具有交互作用（F ＝5.11，P ﹤0.05）；治療第4週末 rTMS 組戒煙率（32.1%）高于偽 rTMS 組（7.4%，P ﹤0.05）；治療前後兩組 PANSS 評分及頭痛髮生率差異無統計學意義。結論：rTMS 能減少精神分裂癥患者的日均吸煙量和尼古丁依賴程度、提高戒煙率，安全性好。
목적：탐토중복경로자자격（rTMS）대문진정신분렬증환자계연적료효급안전성。방법：55례문진정신분렬증합병연초의뢰환자수궤분위 rTMS 조（28례）화위 rTMS 조（27례），분별접수우측배외측전액협피질 rTMS 자격（10Hz，100%운동역치）화위자격，료정4주。입조시화치료제 l、2、4、8주말진행림상평고，이일균흡연량、니고정의뢰량표（FTND）평분、호기말 CO 치급계연솔평정료효，이양성급음성증상량표（PANSS）、불량반응평정안전성。결과：일균흡연량、FTND 평분화호기말 CO치구유조별주효응（F ＝65.33，F ＝25.86，F ＝38.19）화시간주효응（F ＝24.66；F ＝29.92；F ＝18.92）（P ﹤0.05혹 P ﹤0.01）；일균흡연량구유교호작용（F ＝5.11，P ﹤0.05）；치료제4주말 rTMS 조계연솔（32.1%）고우위 rTMS 조（7.4%，P ﹤0.05）；치료전후량조 PANSS 평분급두통발생솔차이무통계학의의。결론：rTMS 능감소정신분렬증환자적일균흡연량화니고정의뢰정도、제고계연솔，안전성호。
Objective:To explore the efficacy and safety of repetitive transcranial magnetic simulation (rTMS)adopted to help outpatients with schizophrenia quit smoking. Method:Fifty-five schizophrenic out-patients with tobacco dependence were randomly divided into rTMS group(n = 28)and sham rTMS group(n =27). The two groups received real or sham rTMS on the right dorsolateral prefrontal cortex(10 Hz and 100%motor threshold)respectivly for 4 weeks. The clinical assessments were conducted before treatment and at the end of 1,2,4,8 weeks after treatment. The curative effect was evaluated according to average daily smoking, score of nicotine dependence scale(FTND),content of carbon monoxide(CO)at end of the breath and smok-ing cessation rate;while the safety assessments were by the positive and negative syndrome scale(PANSS)and dverse reactions. Results:There were group main effect and time main effect on the average daily smoking, score of FTND and CO content at end of the breath(F = 65. 33;F = 25. 86;F = 38. 19)(F = 24. 66;F = 29. 92;F = 18. 92)(P ﹤ 0. 05 or P ﹤ 0. 01). There was group × time interaction on average daily smoking(F = 5. 11, P ﹤ 0. 05). The smoking cessation rate in the rTMS group(32. 1% )at the end of 4th week was significantly higher than the sham rTMS group(7. 4% )(P ﹤ 0. 05). The PANSS scores before and after treatment,the inci-dence of headache between the two groups had no statistical significance. Conclusion:rTMS can effectively reduce the average daily smoking and nicotine dependence in patients with schizophrenia and nicotine depend-ence;improve the smoking cessation rate. And it’s a safer method.
