小剂量氯氮平联合齐拉西酮治疗难治性精神分裂症的临床研究

Effect of combined low-dose clozapine and ziprasidone on treatment of refractory schizophrenia

目的:探讨小剂量氯氮平联合齐拉西酮治疗难治性精神分裂症的方法及疗效。方法:90例难治性精神分裂症患者分为两组,对照组42例单行氯氮平治疗,实验组48例行小剂量氯氮平联合齐拉西酮治疗,对比两组患者的临床疗效,并在治疗后2、4、8周末采用阳性与阴性症状量表(PANSS)和副反应量表(TESS)进行评价。结果:治疗后实验组患者的优良率为93.7%,高于对照组的81.9%,差异有统计学意义(P<0.05);从第2周末开始,两组的PANSS量表评分均逐渐减少(P<0.05),第8周末实验组低于对照组(P<0.05);实验组治疗后TESS不良事件发生率(14.6%)明显低于对照组(28.6%),差异有统计学意义(P<0.05)。结论:小剂量氯氮平联合齐拉西酮治疗难治性精神分裂症,可显著提高临床疗效,改善临床症状,减少不良反应的发生。

Objective： To investigate the effect of combined low-dose clozapine and ziprasidone on treatment of refractory schizophrenia.Methods：A total of 90 refractory schizophrenia patients were randomly divided into two groups,42 cases in control group treated by single clozapine treatment,and 48 in experimental group treated by small doses of clozapine and ziprasidone.The clinical efficacy of two groups were evaluated and compared by using positive and negative syndrome scale（PANSS） and the side effects scale（TESS） scale evaluation at the 2nd.4th and 8th weekend after treatment.Results：The excellent and good rate was 93.7% in experimental group,significantly higher than that of control group（81.9%）（P0.05）.From the 2nd weekend,PANSS scale scores were decreased in two groups（P0.05）.The score was significantly lower in experimental group at the 8th weekend than the control group（P0.05）.And TESS score was significantly lower in experimental group（P0.05）.Conclusions： Low-dose clozapine combined with ziprasidone is effective on treating refractory schizophrenia.Itcan significantly improve the clinical efficacy,improve the clinical symptoms and reduce the incidence of side effects.