齐拉西酮联合小剂量氯氮平治疗难治性精神分裂症的临床观察

Clinical Observation of Ziprasidone Combined with Small-dose of Clozapine in the Treatment of Refractory Schizophrenia

目的:观察齐拉西酮联合小剂量氯氮平治疗难治性精神分裂症的临床疗效与安全性。方法:将120例难治性精神分裂症患者随机分为2组,每组各60例,治疗组给予齐拉西酮联合小剂量氯氮平治疗,对照组给予氯氮平治疗。2组疗程均为12周。采用阳性与阴性症状量表(PANSS)及治疗副反应量表(TESS)于治疗前和治疗后1、2、4、8、12周末各评定1次。结果:从治疗后的第2周末起,2组PANSS的T、P、N、G因子评分与治疗前比较有显著性差异(P<0.05或P<0.01)。在治疗第4周末,2组间PANSS的T、G因子评分的差异有统计学意义(P<0.05);在治疗8周末,2组间PANSS的T、P、N、G因子评分的差异有统计学意义(P<0.01);治疗组均优于对照组。治疗12周末,治疗组总有效率显著高于对照组(P<0.05),且不良反应发生率低于对照组(P<0.05)。结论:齐拉西酮合并小剂量氯氮平治疗难治性精神分裂症的疗效显著,安全性高。

OBJECTIVE： To explore clinical observation of ziprasidone combined with small-doses of clozapine in the treatment of refractory schizophrenia. METHODS： 120 patients with refractory schizophrenia were randomly assigned into 2 groups with each group of 60 cases. Treatment group received ziprasidone and low-dose clozapine while control group received clozapine only for 12 weeks. Clinical efficacy and symptoms were evaluated by positive and negative symptoms rating scale （PANSS） and Symptom Scale （TESS） before treatment and 1, 2, 4, 8, 12 weeks after treatment. RESULTS： After 2 weeks of treatment, the T, P, N, G factor scores of PANSS of both groups were significantly different compared with before treatment （P0.05 or P0.01）; After 4 weeks of treatment, there was significant difference in T and G factor scores between 2 groups （P0.05）; After 8 weeks of treatment, there was significant difference in T, P, N, G factor scores between 2 groups （P0.01）; treatment group was better than control group, After 12 weeks, the total effectiveness between 2 groups was significantly different （P0.05）, and fewer adverse drug reaction was observed in treatment group, compared with control group（P0.05）. CONCLUSION： Ziprasidone combined with small-dose of clozapine is effective and safe for the treatment of refractory schizophrenia.