氯氮平联合舍曲林治疗精神分裂症阴性症状对照研究

A controlled study of clozapine plus sertraline in schizophrenia negative symptoms

目的探讨氯氮平联合舍曲林治疗精神分裂症阴性症状的疗效及安全性。方法将46例以阴性症状为主的慢性精神分裂症患者随机分为两组各23例,研究组口服氯氮平联合舍曲林治疗,对照组口服氯氮平联合安慰剂治疗,观察12w。于治疗前及治疗4w、8w、12w末采用阳性与阴性症状量表和副反应量表评定临床疗效及不良反应。结果治疗12w末研究组总有效率78.3%,对照组60.9%,差异无显著性(χ2=1.643,P>0.05)。研究组治疗4w末起阳性与阴性症状量表总分及各因子分均呈下降趋势,12w末总分及阴性症状因子分显著低于治疗前(P<0.01),且较对照组下降显著(P<0.05或0.01)。两组主要不良反应为流涎、口干、便秘、心动过速等,程度均较轻微。结论氯氮平联合舍曲林治疗可显著缓解精神分裂症患者的阴性症状,且安全性高,依从性好。

Objective To explore the efficacy and safety of clozapine combined with sertraline in negative symptoms of schizophrema. Methods 46 schizophrenia charateristic of negative symptoms were randomly divided into research group（n=23） orally took clozapine plus sertraline and control group（n=23） clozapine plus placebo for 12 weeks. Clinical efficacies were assessed with Positive and Negative Syndrome Scale （PANSS）and side effects with the Treatment Emergent Symptoms Scale（TESS）respectively before treatment and at the ends of the 4th,Sth and 12th week treatment. Results At the end of the 12th week treatment, the total effective rates were 78.3 % of the research group and 60.9 % of the control respectively, the former was higher than the latter, the difference not significant（P〉0.05）. The total and each factor score of the PANSS lowered continously since the end of the 4th week, and at the end of the 12th week the total and negative symptom score were significantly lower in the research group compared with pretreatment （P〈0.01） and than in the control group（P〈0.05 or 0.01）. Main adverse effects of both groups were saliva, dry month, constipation, tachycardia etc and were mild. Conclusion Clozapine plus sertraline can significantly relieve negative symptoms of schizophrenics and has higher safety and better compliance.