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目的:探讨不同频率重复经颅磁刺激（rTMS）治疗首发以阴性症状为主的精神分裂症的疗效，为患者诊疗提供依据。方法:回顾性分析2017年10月至2019年10月丽水市第二人民医院收治的精神分裂症患者84例的临床资料。根据不同治疗频率分5 Hz组、10 Hz组和15 Hz组，每组28例。三组给予对应的5 Hz、10 Hz及15 Hz治疗，1周为1个疗程，共治疗8周。治疗结束时比较效果，记录治疗前、后三组患者阳性与阴性症状量表（PANSS）、阴性症状量表（SANS）、社会功能量表（PSP）、认知功能评定量表（LOTCA）评分变化及不良反应。结果:10 Hz组总有效率为92.86%（26/28），高于5 Hz组的71.43%（20/28）和15 Hz组的67.86%（19/28），差异有统计学意义（χn 2=5.54，n P=0.019）。治疗后，10 Hz组PANSS评分、SANS评分［（61.28±4.16）分、（34.17±5.02）分］均明显高于5 Hz组［（67.19±3.89）分、（42.98±4.17）分］和15 Hz组［（67.10±3.94）分、（43.21±3.56）分］，差异均有统计学意义（n F=20.09、40.38，均n P < 0.001）；治疗后，10 Hz组PSP评分［（60.13±3.78）分］高于5 Hz组［（54.13±4.12）分］和15 Hz组［（53.20±3.79）分］，差异有统计学意义（ n F=26.05，n P < 0.05）；而LOTCA评分［（40.13±4.12）分］低于5 Hz组［（46.28±4.20）分］和15 Hz组［（47.13±3.89）分］，组间差异有统计学意义（ n F=24.64，n P < 0.001）。5 Hz组、10 Hz组、15 Hz组三组不良反应发生率分别为17.86%（5/28）、7.14%（2/28）、14.28%（4/28），差异无统计学意义（χ n 2=1.46，n P=0.481）。n 结论:10 Hz rTMs可有效改善精神分裂症患者的阴性症状，提高患者认知功能及社会功能，具有较高的临床应用价值。“,”Objective:To investigate the therapeutic effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on first-episode schizophrenia with negative symptoms, providing evidence for diagnosis and treatment of this disease.Methods:The clinical data of 84 patients with first-episode schizophrenia with negative symptoms who received treatment in the Second People\'s Hospital of Lishui from October 2017 to October 2019 were retrospectively analyzed. These patients were divided into 5 Hz, 10 Hz, and 15 Hz groups according to different rTMS frequencies (n n = 28/group). Patients in the three groups received 5, 10, and 15 Hz of rTMS. All patients received eight courses of the 1-week treatment. The therapeutic effect was compared between groups at the end of treatment. The scores of the Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), Personal and Social Performance Scale (PSP), and The Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) pre- and post-treatment, as well as adverse reactions, were determined in each group.n Results:Total response rate in the 10 Hz group was 92.86% (26/28), which was significantly higher than that in the 5 Hz group [71.43% (20/28)] and 15 Hz group [67.86% (19/28), n χ2 = 5.54, n P = 0.019]. The scores of PANSS and SANS post-treatment in the 10 Hz group were (61.28 ± 4.16) points and (34.17 ± 5.02) points, respectively, which were significantly higher than those in the 5 Hz group [(67.19 ± 3.89) points, (42.98 ± 4.17) points] and 15 Hz group [(67.10 ± 3.94) points and (43.21 ± 3.56) points,n F = 20.09, 40.38, all n P < 0.001]. The score of PSP post-treatment in the 10 Hz group was (60.13 ± 3.78) points, which was significantly higher than that in the 5 Hz group [(54.13 ± 4.12) points] and 15 Hz group [(53.20 ± 3.79) points, n F = 26.05, n P < 0.05]. The score of LOTCA in the 10 Hz group was (40.13 ± 4.12) points, which was significantly lower than that in the 5 Hz group [(46.28 ± 4.20) points] and 15 Hz group [(47.13 ± 3.89) points, n F = 24.64, n P < 0.001). The incidence of adverse reactions in the 5 Hz, 10 Hz, and 15 Hz groups was 17.86% (5/28), 7.14% (2/28), and 14.28% (4/28), respectively. There was no significant difference in the incidence of adverse reactions among the three groups ( n χ2 = 1.46, n P = 0.481).n Conclusion:10 Hz rTMS can effectively improve the negative symptoms, cognitive function, and social function of schizophrenic patients. The therapy is of high clinical value.