谢宏成,冯双双,王婷婷,梁峻钒,仁佳俊,张虹俐,林资圆,王思入,向波,刘可智.无抽搐电休克治疗联合药物治疗对住院精神分裂症患者的疗效及城乡差异[J].四川精神卫生杂志,2024,37(6):497-501.Xie Hongcheng,Feng Shuangshuang,Wang Tingting,Liang Junfan,Ren Jiajun,Zhang Hongli,Lin Ziyuan,Wang Siru,Xiang Bo,Liu Kezhi,Efficacy of modified electroconvulsive therapy combined with medication in inpatient schizophrenia patients and urban-rural differences[J].SICHUAN MENTAL HEALTH,2024,37(6):497-501

无抽搐电休克治疗联合药物治疗对住院精神分裂症患者的疗效及城乡差异

Efficacy of modified electroconvulsive therapy combined with medication in inpatient schizophrenia patients and urban-rural differences

投稿时间：2024-05-30

DOI：10.11886/scjsws20240530003

中文关键词: 精神分裂症无抽搐电休克治疗城乡

英文关键词:Schizophrenia Modified electroconvulsive therapy Urban and rural areas

基金项目:

作者	单位	邮编
谢宏成	西南医科大学附属医院，四川泸州 646000 西南医科大学，四川泸州 646000	646000
冯双双	西南医科大学附属医院，四川泸州 646000	646000
王婷婷	西南医科大学附属医院，四川泸州 646000	646000
梁峻钒	西南医科大学附属医院，四川泸州 646000	646000
仁佳俊	西南医科大学附属医院，四川泸州 646000	646000
张虹俐	西南医科大学，四川泸州 646000	646000
林资圆	西南医科大学附属医院，四川泸州 646000	646000
王思入	西南医科大学附属医院，四川泸州 646000	646000
向波	西南医科大学附属医院，四川泸州 646000	646000
刘可智^*	西南医科大学附属医院，四川泸州 646000 自贡市精神卫生中心，四川自贡 643020	643020

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中文摘要:

背景抗精神病药物联合无抽搐电休克治疗（MECT）是目前治疗精神分裂症的常用方法，但其疗效在不同患者群体之间可能存在差异。目的比较MECT对在城镇和农村居住的精神分裂症患者的效果，以期为城乡患者的治疗方案选择提供参考。方法纳入2018年5月—2022年8月在泸州市精神卫生中心、自贡市精神卫生中心和宜宾市第四人民医院住院治疗的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）精神分裂症诊断标准的587例患者为研究对象，分为单纯药物组（n=106）和MECT联合药物组（n=481）。在MECT联合药物组中，剔除24例居住地为城镇的农村籍患者，将剩余患者按居住地分为城镇组（n=103）和农村组（n=354）。使用阳性和阴性症状量表（PANSS）评定患者的症状严重程度。采用PANSS评分减分率评定临床疗效。采用协方差分析比较城乡患者的疗效差异。结果 MECT联合药物组和单纯药物组PANSS总评分减分率、阳性症状分量表评分减分率、阴性症状分量表评分减分率以及治疗有效率比较，差异均有统计学意义（F=11.149、12.111、31.725，χ²=14.010，P均<0.01）。MECT联合药物组中的城镇和农村患者PANSS总评分减分率、阳性症状分量表评分减分率以及治疗有效率比较，差异均有统计学意义（F=3.946、4.523，χ²=4.033，P均<0.05）。结论在对住院精神分裂症患者的治疗中，MECT联合药物的疗效可能优于单纯药物治疗。MECT联合药物对城镇患者的疗效可能优于农村患者，且城镇患者阳性症状的改善可能更明显。

英文摘要:

Background Combination of antipsychotic drugs and modified electroconvulsive therapy （MECT） is currently a commonly used method for treating schizophrenia， but its efficacy varies among different patient groups.Objective To explore the therapeutic effects of MECT on schizophrenia patients living in different urban versus rural environments， so as to provide references for the selection of treatment plans based on patients' residence.Methods A total of 587 patients hospitalized at Luzhou Mental Health Center， Zigong Mental Health Center and Yibin Fourth People's Hospital from May 2018 to August 2022， who met the diagnostic criteria for schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5），were included in the study. Patients were divided into two groups： medication-only group （n=106） and MECT combined with medication group （n=481）. In MECT combined with medication group， 24 rural patients residing in urban areas were excluded， leaving the remaining patients divided into urban group （n=103） and rural group （n=354） based on their place of residence. Positive and Negative Syndrome Scale （PANSS） was used to assess the severity of symptoms. Clinical efficacy was evaluated using PANSS score reduction rate， and covariance analysis was used to compare the therapeutic effects of different patients.Results The differences of reduction rate of PANSS total score， positive symptom scale score and negative symptom scale score as well as treatment effectiveness rate between MECT combined with medication group and medication-only group were statistically significant （F=11.149， 12.111， 31.725， χ²=14.010， P<0.01）. Statistically significant differences were also observed in reduction rate of PANSS total score and positive symptom subscale score as well as treatment effectiveness rate between urban and rural patients in MECT combined with medication group （F=3.946， 4.523， χ²=4.033， P<0.05）.Conclusion The efficacy of MECT combined with medication may be superior to medication alone in the treatment of schizophrenia， and the combined therapy may be more effective in urban patients than that in rural patients， with potentially more pronounced improvements in positive symptoms.

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