丁螺环酮对难治性精神分裂症治疗的增效作用

Augmentation effect of buspirone in the treatment of treatment-refractory schizophrenia

目的:探讨丁螺环酮对难治性精神分裂症(TRS)治疗的增效作用与安全性。方法:80例TRS患者随机分入合用组(氯氮平+丁螺环酮)和氯氮平组,每组40例,观察治疗12周。采用阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)分别评定临床疗效和不良反应。结果:在治疗2、4、12周,合用组临床疗效优于对照组(P均<0.05);两组干预后各因子积分和总分均较入组前显著下降(P均<0.001);阳性因子积分和总分,干预与时间存在交互效应(P<0.01);总分存在组间差别(P<0.05);同期对照比较,除入组后8周阴性因子积分和12周阴性因子和一般精神病理因子积分外,其余各时点各因子积分和总分,合用组减分幅度大于对照组(P<0.05)。不良反应总发生率两组间差异无显著性(P>0.05)。结论:丁螺环酮对氯氮平治疗难治性精神分裂症有一定的增效作用,且不增加不良反应。

Objective：To explore the augmentation effect and safety of buspirone in the treatment of the treatment-refractory schizophrenia.Method：All 80 patients with the treatment-refractory schizophrenia were randomly assigned to combined groups（treated with clozapine combined with buspirone） and clozapine group for 12 weeks.Each had 40 cases.The positive and negative syndrome scale（PANSS） and treatment emergent side effect scale（TESS） were used to evaluate the efficacy and adverse effect respectively.Results：After the 2,4,12 weeks treatment,the clinical efficacy in the combined group was significantly better than that in the clozapine group（all P〈0.05）.The total and all facters scores of PANSS after the intervention were significantly lower than those before in the both groups（all P〈0.001）.There were significant interactive effects between time and intervention in the total and positive scores of PANSS（P〈0.01）.The decrease range of those scores in the combined group was significantly greater than that in the clozapine group after the 2 and 4 weeks treatment（P〈0.05）.So as in the 8th except the negative score and in the 12th weekend except the negative and general scores.There was no significant difference between the both groups in the rate of adverse effect（P〉0.05）.Conclusion：Buspirone can significantly improve the efficacy of clozapine in the treatment of the treatment-refractory schizophrenia and won’t add adverse effect also.