非典型抗精神病藥合并丁螺環酮治療精神分裂癥患者的對照研究

蘇明兵,趙霞,張璐平,龔毅,楊建華

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非典型抗精神病藥合并丁螺環酮治療精神分裂癥患者的對照研究

蘇明兵,趙霞,張璐平,龔毅,楊建華

目的探討非典型抗精神病藥(AAPDs)合并丁螺環酮對精神分裂癥患者的治療作用。方法將85 例精神分裂癥患者分為研究組(43例)和對照組(42例),兩組在單一AAPD常規治療基礎上,研究組及對照組分別加用丁螺環酮及安慰劑,療程12周。治療前及治療4、8、12周后分別給予陽性及陰性癥狀量表(PANSS)、韋氏成人智力量表(WAIS-R)、韋氏記憶量表(WMS)評分；治療4、8、12周后給予治療中出現的癥狀量表(TESS)評定；以PANSS減分率評價療效。結果治療第8周起兩組PANSS總分均較治療前明顯降低(P<0.05或P<0.01)；12周末研究組PANSS總分顯著低于對照組(P<0.01)；總有效率(88.4%)顯著高于對照組(71.4%)(P<0.05)；治療8周后兩組WAIS-R總分、言語量表分、操作量表分及WMS分較治療前明顯增高,研究組改善更明顯(P均

非典型抗精神病藥； 丁螺環酮； 精神分裂癥

Abstract：Objective： To explore the therapeutic effect of atypical antipsychotic drugs(AAPDs) combined with buspirone on schizophrenia.Method：Eighty five patients with schizophrenia were divided into study group (43 cases) and control group (42 cases).On the basis of single AAPD treatment,buspirone and placebo were added to the study group and the control group respectively for 12 weeks.The positive and negative symptom scale (PANSS),the Wechsler adult intelligence scale (WAIS-R) and the Wechsler memory scale (WMS) were administered before treatment and 4,8,12 weeks after treatment;After 4,8 and 12 weeks treatment,the treatment emergent symptom scale (TESS) was used to assess adverse reaction.Results：After 8 weeks of treatment,the total scores of PANSS in the two groups were significantly lower than those before treatment (P<0.05 orP<0.01)；The total score of PANSS in the study group was significantly lower than that in the control group at the 12 weekend (P<0.01);The total effective rate (88.4%) was significantly higher than that of the control group (71.4%) (P<0.05);After 8 weeks treatment,WAIS-R total scores,verbal as well as performance score and WMS score of two groups were significantly higher than before treatment,and the study group improved more obviously (P<0.05).Conclusion： Compared with the single AAPDs treatment,AAPDs in combination with buspirone can improve the efficacy and cognitive function without adverse effects increase.

Keywords： atypical antipsychotics； buspirone； schizophrenia

精神分裂癥患者的核心癥狀包括陽性癥狀、陰性癥狀、認知癥狀、情感癥狀及攻擊癥狀；其中陰性癥狀、認知癥狀、情感癥狀對疾病的長期預后和功能恢復更重要。21世紀以來,人們對精神分裂癥治療結果的期望是改善認知功能,提高生活質量。非典型抗精神病藥物(AAPDs)利培酮、氯氮平、阿立哌唑、奧氮平、喹硫平、齊拉西酮對認知功能有一定的改善作用[1]。有文獻[2]報道精神分裂癥患者尸檢發現前額、顳皮質5-羥色胺(5-HT)1A受體密度增加。而且得到功能核磁(PET)的證實。國產丁螺環酮(一舒)作為一個5-HT1A受體部分激動劑在我國廣泛應用于焦慮及抑郁治療,丁螺環酮作用于海馬部位5-HT1A受體,有助于改善精神分裂癥患者的學習和記憶功能,但對精神分裂癥的治療效果不確切,本研究采用隨機雙盲試驗研究丁螺旋酮對精神分裂癥患者認知功能的影響,現報告如下。……