利培酮联合无抽搐电休克治疗难治性精神分裂症对照研究

A control study of risperidone combined with MECT in refractory schizophrenia

目的 比较利培酮联合无抽搐电休克与氯氮平治疗难治性精神分裂症的临床疗效和安全性。方法将60例难治性精神分裂症患者随机分为A、B两组，每组30例，A组口服利培酮联合无抽搐电休克治疗，B组口服氯氮平治疗，观察8周。于治疗前及治疗第2周、4周、6周、8周末采用阳性与阴性症状量表、副反应量表评定临床疗效及不良反应。结果治疗2周末起A组阳性症状、阴性症状因子分较治疗前显著下降（P均〈0．01）；治疗4周末起，两组阳性与阴性症状量表总分及各因子分均较治疗前有显著性下降（P均〈0．05或0．01）；治疗各时段评分A组虽较B组下降显著，但均无显著性差异（P均〉0．05）；治疗8周末，A组有效率62．3%．4，B组为57．0％，两组无显著性差异（P〉0．05）。结论利培酮联合无抽搐电休克治疗难治性精神分裂症疗效与氯氮平相当，但较氯氮平起效快，安全性高，依从性好。

Objective To compare the clinical efficacy and safety of risperidone combined with modified electroconvulsive therapy （MECT） vs. clozapine in refractory schizophrenia. Methods 60 refractory schizophrenics were randomly divided into group A and B（each n=30）, Group A took orally risperidone plus MECT and group B did clozapine for 8 weeks. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale（PANSS） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 2nd,4th,6th and 8th week. Results Since the end of the 2nd week, positive and negative symptom scores lowered more significantly compared with pretreatment in group A （both P〈0.01） ;sing the end of the 4th week, the PANSS toatl and all factors scores of both groups lowered more significantly compared with pretreatment（all P〈0.05 or 0.01） ;although in each peroid after treatment those lowered more significantly in the group A than in the group B, differences were not significant（all P〉0.05）;at the end of the 8th week, effective rates were respectively 62. 3% in group A and 57.0% B, which showed no significant difference（P〉0.05）. After treatment, the incidences of adverse ractions were significantly lower in group A than B（P〈0.05）. Conclusion Risperidone combined with MECT has an ecident effect equivalent to clozapine in refractory schizophrenia,but the former takes effects faster, has mild adverse reactions and higher safety.