摘要
目的探讨阿立哌唑联合小剂量氯氮平治疗首发精神分裂症的临床疗效。方法选择2015年1月~2016年1月住院治疗的首发精神分裂症患者70例,将70例患者随机分为观察组和对照组,每组35例,对照组予氯氮平初始剂量为50 mg/d,2周内渐加量至250~400 mg/d,疗程8周,可酌情使用β-受体阻滞剂、抗胆碱能药物和对症治疗的药物。观察组同时联合阿立哌唑初始剂量10 mg/d,每日1次口服,最大剂量30 mg/d,疗程8周,整个治疗过程中根据病情可酌情使用苯二氮卓类药和抗胆碱药。两组均不合并使用其他抗精神病药物。结果观察组治疗后的总有效率达94.29%,明显高于对照组83.86%,两组总有效率比较,差异无统计学意义(P>0.05)。观察组与对照组患者治疗前的PANSS各项评分阳性症状、阴性症状、一般精神病理及总分组间比较,差异不显著(P>0.05)。但治疗后4周、8周,观察组患者的PANSS各项评分阳性症状、阴性症状、一般精神病理及总分分别显著低于对照组,组间差异有统计学意义(P<0.05)。观察组的并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论阿立哌唑联合小剂量氯氮平治疗首发精神分裂症疗效确切,可以显著改善患者的临床症状,不良反应少,安全性好,值得广泛推广和应用。
Objective To investigate the clinical efficacy of aripiprazole combined with small-dose clozapine in the treatment of first-episode schizophrenia. Methods 70 patients with first-episode schizophrenia who were hospitalized from January 2015 to January 2016 were selected. 70 patients were randomly divided into the observation group and the control group, with 35 cases in each group. The control group was given clozapine with the initial dosage of 50 mg/ d, and the dosage was gradually increased to 250-400 mg/d, with the course of treatment of 8 weeks. β-receptor blocker, anticholinergic drugs and symptomatic drugs were appropriately applied. The observation group was given combined aripiprazole with the initial dosage of 10 mg/d, orally administered once a day at a maximum dose of 30 mg/d. The course of treatment was 8 weeks. Benzodiazepines and anticholinergics could be appropriately applied during the entire treatment process according to the disease. Other antipsychotic drugs were not used in combination in both groups. Results The total effective rate after treatment was 94.29% in the observation group, which was significantly higher than that of 83.86% in the control group, there was no statistically significant difference in the curative effect between the two groups （P〉0.05）. There were no significant differences in the scores of positive symptoms, negative symptoms, general psychopathology and total score of PANSS before the treatment between the observation group and the control group（P〉0.05）. After 4 weeks and 8 weeks of the treatment, the scores of positive symptoms, negative symptoms, general psychopathology and total score of PANSS in the observation group were significantly lower than those in the control group, and the differences between groups were statistically significant （P〈0.05）. The incidence rate of complications in the observation group was significantly lower than that in the control group, and the difference between groups was statistically significant（P〈0.05）. Conclusion Aripiprazole combined with small-dose clozapine is effective in the treatment of first-episode schizophrenia, which can significantly improve patients＇ clinical symptoms, with less adverse reactions and good safety, and is worthy to be widely popularized and applied.
出处
《中国现代医生》
2017年第17期92-95,共4页
China Modern Doctor
基金
国家自然基金青年资助项目(81501160)
浙江省卫计委科研计划项目(2015KYB368)
江苏省青年医学人才项目(QNRC2016228)
浙江省温州市科技计划项目(Y20160073)
江苏省苏州市科技局项目(SYSD2013149)
