利培酮联合碳酸锂治疗分裂情感性精神病的对照研究

Risperdal Combined with Lithium Carbonate in the Treatment of Schizo-affective Disorder

目的评价利培酮联合碳酸锂治疗分裂情感性精神病的临床疗效及安全性。方法根据躁狂评定量表(BRMS)总分≥16分,汉密尔顿抑郁量表(HAMD)总分≥17分,阳性与阴性症状量表(PANSS)总分≥65分的82例诊断为分裂情感性精神病的患者随机分成两组,分别口服利培酮联合碳酸锂或氯氮平联合碳酸锂治疗,观察8周。于治疗前及治疗2周、4周和8周末采用PANSS、HAMD、BRMS和副反应量表(TESS)4套量表评定临床疗效和不良反应。结果以PANSS、HAMD、BRMS减分率判定临床疗效,治疗8周末,研究组PANSS总分显效率57.5%,有效率95%,对照组10%,62.5%。两组比较有显著性差异(t1=-2.07,P1=0.04;t2=-29.64,P2<0.01);研究组HAMD显效率85%,有效率95%,对照组60%,77.5%。两组比较有显著性差异(t1=-5.63,P1<0.01;t2=-6.57,P2<0.01);研究组BRMS显效率85%,有效率95%,对照组10%,70%。两组比较有显著性差异(t1=-14.89,P1<0.01;t2=-17.75,P2<0.01)。故利培酮组和氯氮平组在治疗8周末的临床疗效有显著差异,且利培酮组的不良反应发生率低于氯氮平组,差异有显著性(P<0.01)。结论利培酮组治疗分裂情感性精神病疗效显著,安全性高,依从性好,能显著提高患者的生活质量。

Objective To explore the efficacy and safety of risperdal combined with lithium carbonate in the treatment of schizo-affective disorder.Methods A total of 82 patients with schizo-affective disorder who met the diagnostic criteria were randomly divided into two groups,namely oral risperdal combined with lithium carbonate and clozapine（or joint lithium carbonate treatment,observation 8 weeks.Before treatment and in 2 weeks,4 weeks and 8 weekend,using HAMD,BRMS by PANSS and TESS to assess clinical curative effect and adverse reaction.Results In 8 week treatment,the efficient rate was 57.5% and the effective rate was 95% in study group,and the control group showed 10% efficiency,the effective rate was 62.5%,there were significant differences between two groups（t1=-2.07,P1=0.04;t2=-29.64,P20.01）;HAMD significant efficiency 85%,the effective rate was 95%,and the control group significant efficiency of 60%,the effective rate was 77.5%.significant efficiency,efficient of two groups were significantly different（t1=-5.63,P10.01;t2=-6.57,P20.01）;BRMS minus points of significant efficiency rate of 85%,the effective rate was 95%,and the control group significant efficiency of 10%,the effective rate was 70%.significant efficiency and efficient of two groups was significant difference（t1=-14.89,P10.01;t2=-17.75,P20.01）.Risperidone group had a lower incidence of adverse reactions than clozapine group（P0.01）.Conclusion Risperdal in the treatment of schizo-affective disorder has a good curative effect,high safety and good compliance,it can significantly improve the quality of life of patients.