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目的 探讨不同频率重复经颅磁刺激治疗老年精神分裂症患者临床疗效.方法 选择温州医科大学附属康宁医院2018年2月至2019年8月收治的老年精神分裂症患者70例,按照随机数字表法分为观察组35例与对照组35例.观察组采用高频重复经颅磁刺激治疗,对照组采用低频重复经颅磁刺激治疗.两组疗程均为4周.比较两组治疗前后临床疗效总评量表(CGI)评分、阳性和阴性症状量表(PANSS)评分、精神分裂症认知功能评定量表(SCoRS)评分、住院精神病人社会功能评定量表(SSPI)评分和血清性激素水平变化.结果 两组治疗后CGI评分和PANSS评分较治疗前降低[观察组:(2.43±0.37)分比(5.61±0.58)分、(35.73±6.57)分比(79.95±8.98)分,t=27.346、23.512;对照组:(3.37±0.48)分比(5.49±0.62)分、(40.91±8.17)分比(78.64±9.63)分,t=15.996、17.675,P＜0.05];观察组治疗后CGI评分和PANSS评分低于对照组(t=9.176、2.923,P＜0.05).两组治疗后SCoRS评分较治疗前降低(观察组:t=12.822;对照组:t=7.402,P＜0.05);观察组治疗后SCoRS评分低于对照组[(27.92±5.41)分比(34.25±6.17)分,t=4.564,P＜0.05)].两组治疗后SSPI评分较治疗前增加(观察组:t=9.252;对照组:t=3.671,P＜0.05);观察组治疗后SSPI评分高于对照组[(35.74±3.27)分比(30.85±2.28)分,t=7.257,P＜0.05)].两组治疗后血清睾酮和泌乳素水平较治疗前升高(观察组:t=13.853、15.198;对照组:t=10.075、9.225,P＜ 0.05);观察组治疗后血清睾酮和泌乳素水平高于对照组(t=5.693、7.202,P＜0.05).结论 高频重复经颅磁刺激治疗老年精神分裂症患者效果优于低频重复经颅磁刺激,且改善性激素水平优于低频重复经颅磁刺激,改善患者认知功能和社会功能优于低频重复经颅磁刺激.“,”Objective To explore the clinical study of different frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia.Methods The 70 elderly schizophrenics admitted to Kangning Hospital Affiliated to Wenzhou Medical University from February 2018 to August 2019 were randomly divided into observation group (35 cases) and control group (35 cases).High frequency repetitive transcranial magnetic stimulation was used in the observation group and low frequency repetitive transcranial magnetic stimulation was used in the control group.Both groups were treated for 4 weeks.The changes of clinical global impression (CGI),positive and negative syndrome scale (PANSS),cognitive function rating scale for schizophrenia (SCoRS),scale of social-skills for psychiatric inpatients(SSPI) and serum sex hormone levels before and after treatment were compared between the two groups.Results After treatment,the CGI and PANSS scores of the two groups were lower than those before treatment [observation group:(2.43 ± 0.37) scores vs.(5.61 ± 0.58) scores,(35.73 ± 6.57) scores vs.(79.95 ± 8.98) scores,t =27.346 and 23.512;control group:(3.37 ± 0.48) scores vs.(5.49 ± 0.62) scores,(40.91 ± 8.17) scores vs.(78.64 ± 9.63) scores,t =15.996 and 17.675,P ＜ 0.05];after treatment,the CGI and PANSS scores of the observation group were lower than those of the control group (t =9.176,2.923,P ＜ 0.05).After treatment,the SCoRS scores of the two groups was lower than those before treatment (observation group:t =12.822,control group:t =7.402,P ＜ 0.05);after treatment,the SCoRS score of the observation group was lower than that of the control group [(27.92 ± 5.41) scores vs.(34.25 ± 6.17) scores] (t=4.564,P＜0.05).The SSPI scores of the two groups increased after treatment (observation group:t=9.252;control group:t=3.671,P＜0.05);after treatment,the SSPI scores of the observation group were higher than those of the control group [(35.74 ± 3.27) scores vs.(30.85 ± 2.28) scores](t =7.257,P ＜ 0.05).After treatment,the serum testosterone and prolactin levels in the two groups were higher than those before treatment (observation group:t =13.853,15.198;control group:t =10.075 and 9.225,P ＜ 0.05);after treatment,the serum testosterone and prolactin levels in the observation group were higher than those in the control group (t=5.693 and 7.202,P＜0.05).Conclusions High frequency repetitive transcranial magnetic stimulation is superior to low frequency repetitive transcranial magnetic stimulation in the treatment of senile schizophrenia,and the improvement of sex hormone level is superior to low frequency repetitive transcranial magnetic stimulation,and the improvement of cognitive and social functions is superior to low frequency repetitive transcranial magnetic stimulation.