丁螺环酮与抗精神病药物联用治疗精神分裂症患者病理性或药源性焦虑的疗效观察

Observation of Clinical Effects of Buspirone Combined with Antipsychotic Drugs in the Treatment of Schizophrenia with Psychopathology and Drug-induced Anxiety

目的:观察丁螺环酮与抗精神病药物联用治疗精神分裂症患者病理性或药源性焦虑的疗效。方法:将2008年2月-2012年2月在我院就诊的精神分裂症患者240例,按疾病类型的不同随机分为单用抗精神病药物组(A组)和抗精神病药物联用丁螺环酮组(B组)。A组患者用药包括氯丙嗪、氯氮平、阿立哌唑、利培酮,B组患者为氯丙嗪、氯氮平、阿立哌唑、利培酮分别与丁螺环酮联用。然后进行各药物的单用和联用两两配对观察,共计4对、8小组,每小组纳入病例30例。采用汉密尔顿焦虑量表(HAMA)和阳性与阴性症状量表(PANSS)于入组前和入组后1、2、4、8、12周末各评定1次,对焦虑症状缓解程度及治疗效果进行比较。结果:各个时间点的HAMA和PANSS减分B组均快于A组(P<0.05或P<0.01),B组的抗精神病药物用量也少于A组(P<0.01),但总有效率两组比较差异无统计学意义(P>0.05)。所有患者用药过程中均未见不良反应发生。结论:抗精神病药物与丁螺环酮联合使用可快速缓解精神病患者的精神症状,且可减少抗精神病药物的用量,安全性较好。

OBJECTIVE： To investigate therapeutic efficacies of buspirone combined with antipsychotic drugs in the treatment of schizophrenia with psychopathology and drug-induced anxiety. METHODS ： 240 patients with schizophrenia were randomly divid- ed into antipsychotic drugs alone group （group A） and antipsychotic drugs combined with buspirone （group B） in our hospital dur- ing Feb. 2008--Feb. 2012. Group A received chlorpromazine, clozapine, aripiprazole and risperidone, and group B was given bus- pirone combined with clozapine, aripiprazole or risperidone. Therapy of single drug and two-drug were observed. A total of 4 pairs and 8 groups were formulated with 30 cases in each group. Therapeutic efficacy was evaluated with HAMA and PANSS before and 1, 2, 4, 8, 12 weeks of therapy. RESULTS： The reduction rates of HAMA and PANSS in drug combination group were higher than in single group at different time points （P^0.05 or P^0.01）. The amount of antipsychotic drugs in drug combination group was less than in single drug group （P〈0.01）, but there was no significant difference in total effective rate between 2 groups （P〉 0.05）. No ADR occurred in every group. CONCLUSIONS： Antipsychotic drugs combined with buspirone relieve psychotic symptoms rapidly, and fewer amounts of antipsychotic drugs are used.