| BackgroundSchizophrenia is a chronic persistent disease,clinical symptom is complicated,have characteristics of thought,emotion,behavior coordination and from the characteristics of the realistic environment,but some residual symptoms such as hallucinations and negative symptoms still affects the social function and life quality of patients.Repetitive transcranial magnetic stimulation(Repetitive Transcranial Magnetic Stimulation,rTMS)therapy is the therapy of mental disorders in a new non invasive physical therapy method,has been widely used in mental depression and schizophrenia,anxiety disorder,obsessive compulsive disorder,and achieved obvious effect.Provides a new way for the therapy of clinical symptoms of schizophrenia.Objectives(1)To study the low-frequency rTMS of mental division disease refractory auditory hallucinations in patients with therapeutic effect;(2)Observed before and after low frequency rTMS therapy schizophrenia patients cognitive function and negative and positive symptoms change,for rTMS parameter is chosen to provide clinical basis.MethodTo conform to the international classification of diseases,10 th Edition(ICD-10)spirit division disease diagnosis standard of 52 patients as the research object,the positive and negative symptom scale table(PANSS)scores over 60.Those were divided into study team(n=26)and contrast team(n=26),study team application of rTMS really exciting combined with antipsychotic drug therapy intervention,cases in the contrast team rTMS application sham stimulation combined with antipsychotic for therapeutic intervention.Antipsychotic drug.RTMS treated by 1Hz low frequency magnetic stimulation,the site of action for the left temporal parietal area(DLPFC),the intensity of 80% motor threshold.Two patients in reach team were fixed for 6 weeks.In 25 healthy volunteers as normal contrast team.Study team and the contrast team in before rTMS therapy,therapy 2 weeks,therapy 4 weeks,therapy 6 weeks application of PANSS scale to assess mental symptoms.Before therapy,therapy of 4 weeks,therapy 6 weeks using P300 and WCST to assess cognitive function and therapy in the therapy of adverse reaction was table(Teatment emergent Symptomscale Tess)rTMS and drug related adverse reactions of situation assessment.Healthy volunteers only do a P300 check and Wisconsin scale assessment.All the data into the computer,using SPSS 16.0 for statistical analysis,variance analysis,samples T-test,Pearson correlation analysis statistical repeated measurement.Result1.rTMS combinated with antipsychotic therapy of schizophrenia patients with auditory hallucinationComparison within teams: compared with before therapy,2 weeks of therapy,there are no distinct between the two teams(P > 0.05);4 weeks,6 weeks as a therapy for auditory hallucinations compared to before,the distinct is remarkably significant(P<0.05);and case-contrast compared with that before the therapy team of the same,2 week,4 week distinct not remarkably(P > 0.05);6 weeks of therapy,the distinct is remarkably significant(P< 0.05).Comparison between teams: before therapy,study team and contrast team,phonism comparison,no remarkably significant distinct(P > 0.05).After 2 weeks of therapy,reach team was higher than the contrast team improved phonism,however,there were not distinct(P > 0.05).After 4 weeks,6 weeks,reach team auditory hallucinations turn for the better and were compared to the contrast team,the distinct was significant(P < 0.05).2.rTMS in combination with antipsychotics on cognitive function in schizophrenia combined(1)rTMS in combination with antipsychotic drugs on P300 in patients with schizophreniaComparison between teams: Before therapy,the distinct was remarkably significant between the three teams(P < 0.05),compared with the teams before therapy.Compared with the contrast team,reach team had no statistical significance compared with the contrast team(P > 0.05).In the 4 week therapy,there was higher significantly of latency of P3 and NP3 in three teams.The amplitude was significantly lower than that of reach team and the contrast team,the distinct was remarkably significant(P < 0.05).There was lower significantly of latency of P3 and NP3 of the contrast team than that of reach team.study team had statistical significance compared with the contrast team(P < 0.05).At the end of 6 weeks,the distinct of P3 and NP3 latency was not significant between the two teams(P > 0.05);case-contrast P300 latencies of P3 and NP3 is higher than that of reach team and normal contrast team,the amplitude is lower than that in Study Team and normal contrast team(P < 0.05).Comparison within teams: Compared with before therapy,4 weeks therapy,research team,P300 shortened the latencies of P3 and NP3,higher amplitude than that before therapy,the distinct is remarkably significant(P < 0.05);case contrast team,P300 in P3 and NP3 latency and amplitude did not change significantly,the distinct was not remarkably significant(P > 0.05).Therapy 6 weekend,reach team and the contrast team P300 P3 and NP3 incubation period was shortened,the amplitude was increased,which was remarkably different(P < 0.05).(2)rTMS combined with antipsychotic drugs on WCST in patients with schizophreniaComparison between teams: Before therapy,the total score of WCST scale between the three teams was compared,compared with before therapy,2 weeks of therapy,there are no distinct between the two teams(P > 0.05);4 weeks,6 weeks as a therapy for auditory hallucinations compared to before,the distinct is remarkably significant(P<0.05);and case-contrast compared with that before the therapy team of the same,2 weekend,4 weekend,which was not remarkably different(P > 0.05),the error should be the answer,persistent responses and sustained error number and completion of the first classification required should be solution therapy is decreased,the distinct was not remarkably significant(P > 0.05).Therapy 6 weeks,reach team WCST Scale total score and the case contrast team,which was not remarkably different(P > 0.05),compared with the normal contrast team,which was not remarkably different(P > 0.05).Comparison within teams: Compared with before therapy,6 weeks of therapy,study team WCST scale number of categories completed,correct answer and conceptual level responses percentage were compared with those before therapy increased(P > 0.05)error should be the answer,persistent responses and sustained error number and completion of the first classification required responses compared with those before therapy decreased(P > 0.05).The total score of WCST scale in the case contrast team was not significant(P > 0.05).After 6 weeks therapy,study team and contrast team,the scores of WCST were higher than that before therapy,but which was not remarkably different(P > 0.05).3.rTMS combined with antipsychotic drugs on negative and positive symptoms of schizophreniaComparison between teams: Before therapy,the total score of PANSS,negative symptoms,positive symptoms and general mental pathology in reach team were compared with the contrast team,which was not remarkably different(P > 0.05).In the 2 week of therapy,the total score of PANSS,negative symptoms,positive symptoms and general mental pathology in reach team were lower than that in the contrast team,which was not remarkably different(P < 0.05).In the 4 week of therapy,the total score of PANSS,negative symptoms,positive symptoms and general spirit of the contrast team were higher than which of study team,which was different(P < 0.05).In the 6 week of therapy,the total score of PANSS,negative symptoms,positive symptoms and general mental and pathological scores which are higher than that study team,which was different(P < 0.05).Comparison within teams: Compared with before therapy,2 weeks of therapy,study team of PANSS total score,negative symptom and general psychopathology scores lower than the therapy,the distinct was not remarkably significant(P > 0.05);case contrast PANSS total score and each factor had no significant change(P > 0.05).The total score of PANSS and the factor scores of reach team and the contrast team were significantly lower than no-therapy,which was different(P < 0.05).Conclusion1.Compared with single antipsychotic drug therapy,1Hz rTMS therapy combined with antipsychotic drug therapy can significantly improve schizophrenic patients with auditory hallucination.2.Compared with the single use of antipsychotic drugs,1Hz rTMS combined with antipsychotic drug therapy can improve the attention,memory and executive function of schizophrenia patients,so as to improve the cognitive function of patients. |
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