摘要

摘要
目的：探讨重复经颅磁刺激联合氯氮平治疗难治性精神分裂症(treatment resistant schizophrenia, TRS)伴激越行为的临床疗效。

方法：观察对象为2023年9月-2025年6月84例TRS伴激越行为患者，数字表法随机分为2个组别。对照组42例，采用氯氮平治疗，观察组42例采用重复经颅磁刺激联合氯氮平治疗，治疗4周。比较2组治疗前后阳性与阴性症状量表、激越情绪行为量表评分、副反应量表。

结果：治疗后2组阳性、阴性及精神病理症状评分均显著下降，但观察组均低于对照组，（P<0.05）；治疗后2组激越行为评分均显著下降，但观察组均低于对照组，（P<0.05）；观察组治疗2周、4周时副反应评分显著低于对照组，（P<0.05）。

结论：重复经颅磁刺激联合氯氮平治疗TRS伴激越行为能够进一步降低阳性与阴性症状，减轻激越行为，降低副反应。

关键词：关键词：重复经颅磁刺激;氯氮平;难治性精神分裂症;激越行为

ABSTRACT

[Abstract]
Objective To investigate the clinical efficacy of repetitive transcranial magnetic stimulation combined with clozapine in treating treatment-resistant schizophrenia (TRS) with agitated behavior.

Methods Eighty-four patients with TRS and agitated behavior from September 2023 to June 2025 were enrolled into this study. Participants were randomly assigned to two groups using a digital table method. The control group (n=42) received clozapine treatment, while the observation group (n=42) received combined treatment of repetitive transcranial magnetic stimulation (rTMS) and clozapine for 4 weeks. The study compared pre- and post-treatment scores on the Positive and Negative Symptom Scale (PANSS), the Agitated Emotional Behavior Scale (AEBS), and the Adverse Reaction Scale between the two groups.

Results After treatment, both groups showed significant reductions in positive and negative symptom scores as well as psychopathology symptom scores, but the observation group remained lower than the control group (P<0.05). Both groups exhibited significant decreases in agitation behavior scores post-treatment, yet the observation group remained lower than the control group (P<0.05). At 2- and 4-weeks post-treatment, the observation group demonstrated significantly lower adverse reaction scores compared to the control group (P<0.05).

Conclusion   Repetitive transcranial magnetic stimulation combined with clozapine treatment for TRS with agitated behavior can further reduce positive and negative symptoms, alleviate agitated behavior, and decrease adverse reactions.

Key words: Key words Repetitive Transcranial Magnetic Stimulation; Clozapine; Treatment-Resistant Schizophrenia; Agitated Behavior