盐酸丁螺环酮片联合利培酮片对稳定期精神分裂症患者阴性症状的疗效观察
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摘要
目的探讨盐酸丁螺环酮片联合利培酮片对稳定期精神分裂症患者阴性症状的疗效。方法选择2014年1月至2016年1月北京市怀柔安佳医院门诊就诊的稳定期精神分裂症患者60例。应用随机数字表将60例患者分为2组,各30例。对照组维持入组时利培酮片治疗剂量,观察组维持入组时利培酮片治疗剂量,基线期评估后开始联合盐酸丁螺环酮片治疗。分别于基线和治疗4、8周末应用阳性与阴性症状量表(PANSS)进行症状评估,以阴性症状量表作为主要疗效指标;应用不良反应量表观察2组患者的药物不良反应。结果 2组患者基线资料比较差异均无统计学意义(均P>0.05)。在基线期,2组PANSS评分比较差异均无统计学意义(均P>0.05)。治疗4周,2组PANSS评分及与本组基线比较差异均无统计学意义(均P>0.05)。治疗8周观察组的阴性症状量表评分低于本组基线期及治疗4周,且低于对照组同时点[(15±4)分比(18±5)、(17±4)、(18±5)分],差异均有统计学意义(均P<0.05)。2组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论利培酮片联合盐酸丁螺环酮片对改善稳定期精神分裂症患者阴性症状安全有效。
Objective To observe the effect of buspirone hydrochloride tablets combined with risperidone tablets on negative symptoms of stable schizophrenia. Methods A total of 60 patients with schizophrenia of stable phase in BeiJing Huairou Anjia Hospital from January 2014 to January 2016 were randomly divided into observation group and control group, with 30 cases in each group. The control group was treated with buspirone hydrochloride tablets; the observation group was treated with buspirone hydrochloride tablets combined with risperidone tablets.The Positive and Negative Symptom Scale(PANSS) was used to evaluate the therapeutic effect; the Treatment Emergent Symptom Scale was used to evaluate adverse reactions. Results The PANSS score showed no significant difference between groups before treatment and 4 weeks after treatment( P > 0. 05). Eight weeks after treatment,the negative symptom score in observation group was significantly lower than that before treatment and 4 weeks after treatment; the negative symptom score in observation group was significantly lower than that in control group[(15±4) vs(18 ±5),(17 ±4),(18 ±5)](P<0.05). There was no significant difference of incidence of adverse reactions between groups(P > 0. 05). Conclusion Risperidone combined with buspirone hydrochloride is safe and effective in treatment of the negative symptoms of stable schizophrenia.
Objective To observe the effect of buspirone hydrochloride tablets combined with risperidone tablets on negative symptoms of stable schizophrenia. Methods A total of 60 patients with schizophrenia of stable phase in BeiJing Huairou Anjia Hospital from January 2014 to January 2016 were randomly divided into observation group and control group, with 30 cases in each group. The control group was treated with buspirone hydrochloride tablets; the observation group was treated with buspirone hydrochloride tablets combined with risperidone tablets.The Positive and Negative Symptom Scale(PANSS) was used to evaluate the therapeutic effect; the Treatment Emergent Symptom Scale was used to evaluate adverse reactions. Results The PANSS score showed no significant difference between groups before treatment and 4 weeks after treatment( P > 0. 05). Eight weeks after treatment,the negative symptom score in observation group was significantly lower than that before treatment and 4 weeks after treatment; the negative symptom score in observation group was significantly lower than that in control group[(15±4) vs(18 ±5),(17 ±4),(18 ±5)](P<0.05). There was no significant difference of incidence of adverse reactions between groups(P > 0. 05). Conclusion Risperidone combined with buspirone hydrochloride is safe and effective in treatment of the negative symptoms of stable schizophrenia.
引文
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[13]崔鹏.精神分裂症阴性症状的治疗[J].四川精神卫生,2014,27(3):288,后插1-2.DOI:10.3969/j.issn.1007-3256.2014.03.035.Cui P.Treatment of negative symptoms of schizophrenia[J].Sichuan Mental Health,2014,27(3):288,posterior insertion 1-2.DOI:10.3969/j.issn.1007-3256.2014.03.035.
[14]张婧,侯钢.丁螺环酮在精神科应用的研究进展[J].临床精神医学杂志,2013,23(6):419-421.Zhang J,Hou G.Research progress in the application of buspirone in the psychiatry department[J].Sichuan Mental Health,2013,23(6):419-421.
[15]Brody D,Adler LA,Kim T,et al.Effects of buspirone in seven schizophrenic subjects[J].J Clin Psychopharmacol,1990,10(1):68-69.
[16]薛世琦.丁螺环酮对精神分裂症患者认知功能的影响研究[J].中外医疗,2016,35(19):106-107.DOI:10.16662/j.cnki.1674-0742.2016.19.106.Xue SQ.Effect of buspirone on the cognitive function in stable schizophrenia patients[J].China Foreign Medical Treatment,2016,35(19):106-107.DOI:10.16662/j.cnki.1674-0742.2016.19.106.
[17]廖金敏,阎浩,刘琦,等.精神分裂症患者认知功能受损和阴性症状的关系[J].中国全科医学,2015,18(30):3666-3670.DOI:10.3969/j.issn.1007-9572.2015.30.007.Liao JM,Yan H,Liu Q,et al.Relationship between cognitive deficits and negative symptoms in patients with schizophrenia[J].Chinese General Practice,2015,18(30):3666-3670.DOI:10.3969/j.issn.1007-9572.2015.30.007.
[2]Yu Y,Liu ZW,Tang BW,et al.Reported family burden of schizophrenia patients in rural China[J].PLoS One,2017,12(6):e0179425.DOI:10.1371/journal.pone.0179425.
[3]M(o|¨)ller HJ.Management of the negative symptoms of schizophrenia:new treatment options[J].CNS Drugs,2003,17(11):793-823.
[4]Vaskinn A,Ventura J,Andreassen OA,et al.A social path to functioning in schizophrenia:From social self-efficacy through negative symptoms to social functional capacity[J].Psychiatry Res,2015,228(3):803-837.DOI:10.1016/j.psychres.2015.05.019.
[5]Erhart SM,Marder SR,Carpenter WT.Treatment of schizophrenia negative symptoms:future prospects[J].Schizophr Bull,2006,32(2):234-237.
[6]Wang SM,Han C,Lee SJ,et al.Investigational dopamine antagonists for the treatment of schizophrenia[J].Expert Opin Investig Drugs,2017,26(6):687-698.DOI:10.1080/13543784.2017.1323870.
[7]Maurel M,Belzeaux R,Adida M,et al.Negative symptoms:which antipsychotics?[J].Encephale,2015,41(6 Suppl 1):6S32-35.DOI:10.1016/S0013-7006(16)30008-2.
[8]Ghaleiha A,Noorbala AA,Farnaghi F,et al.A double-blind,randomized,and placebo-controlled trial of buspirone added to risperidone in patients with chronic schizophrenia[J].J Clin Psychopharmacol,2010,30(6):678-682.
[9]张明园.抗精神病药维持期优化治疗的原则[J].中华精神科杂志,2014,47(3):169.DOI:10.3760/cma.j.issn.1006-7884.2014.03.011.Zhang MY.The principle of optimal treatment for antipsychotics during the maintenance period[J].Chinese Journal of Psychiatry,2014,47(3):169.DOI:10.3760/cma.j.issn.1006-7884.2014.03.011.
[10]王欣,马东梅,孟璇,等.长期服用氯氮平的慢性精神分裂症患者颈部、颅内动脉粥样硬化病变的研究[J].临床内科杂志,2016,33(6):393-395.DOI:10.3969/j.issn.1001-9057.2016.06.010.Wang X,Ma DM,Meng X,et al.The study of atherosclerosis for carotid arteries and intracranial arteries in chronic schizophrenic patients treated with clozapine for long durations[J].Journal of Clinical Internal Medicine,2016,33(6):393-395.DOI:10.3969/j.issn.1001-9057.2016.06.010.
[11]宋伊娜.精神分裂症误诊为旅途性精神病原因分析[J].临床误诊误治,2016,29(10):63-64.DOI:10.3969/j.issn.1002-3429.2016.10.020.Song YN.Analysis of the causes of schizophrenia misdiagnosed as traveling psychosis[J].Clinical Misdiagnosis&Mistherapy,2016,29(10):63-64.DOI:10.3969/j.issn.1002-3429.2016.10.020.
[12]王龙书.奥氮平联合阿立哌唑对首发精神分裂症女性患者血糖及血脂水平的影响[J].中国医药,2017,12(10):1525-1528.DOI:10.3760/cma.j.issn.16734777.2017.10.021.Wang LS.Effect of olanzapine combined with aripiprazole on blood glucose and lipid levels in female patients with first episode of schizophrenia[J].China Medicine,2017,12(10):1525-1528.DOI:10.3760/cma.j.issn.1673-4777.2017.10.021.
[13]崔鹏.精神分裂症阴性症状的治疗[J].四川精神卫生,2014,27(3):288,后插1-2.DOI:10.3969/j.issn.1007-3256.2014.03.035.Cui P.Treatment of negative symptoms of schizophrenia[J].Sichuan Mental Health,2014,27(3):288,posterior insertion 1-2.DOI:10.3969/j.issn.1007-3256.2014.03.035.
[14]张婧,侯钢.丁螺环酮在精神科应用的研究进展[J].临床精神医学杂志,2013,23(6):419-421.Zhang J,Hou G.Research progress in the application of buspirone in the psychiatry department[J].Sichuan Mental Health,2013,23(6):419-421.
[15]Brody D,Adler LA,Kim T,et al.Effects of buspirone in seven schizophrenic subjects[J].J Clin Psychopharmacol,1990,10(1):68-69.
[16]薛世琦.丁螺环酮对精神分裂症患者认知功能的影响研究[J].中外医疗,2016,35(19):106-107.DOI:10.16662/j.cnki.1674-0742.2016.19.106.Xue SQ.Effect of buspirone on the cognitive function in stable schizophrenia patients[J].China Foreign Medical Treatment,2016,35(19):106-107.DOI:10.16662/j.cnki.1674-0742.2016.19.106.
[17]廖金敏,阎浩,刘琦,等.精神分裂症患者认知功能受损和阴性症状的关系[J].中国全科医学,2015,18(30):3666-3670.DOI:10.3969/j.issn.1007-9572.2015.30.007.Liao JM,Yan H,Liu Q,et al.Relationship between cognitive deficits and negative symptoms in patients with schizophrenia[J].Chinese General Practice,2015,18(30):3666-3670.DOI:10.3969/j.issn.1007-9572.2015.30.007.