小剂量氨磺必利联合利培酮治疗首发精神分裂症阴性症状随对照研究

Randomized Open-controlled Trial of Low-dose Amisulpride Combined Risperidone in Treatment of Negative Symptoms in Patients with Firs-episodeSchizophrenia

目的比较小剂量氨磺必利联合利培酮和单用利培酮治疗精神分裂症阴性症状的疗效。方法住院首发精神分裂症患者,经利培酮治疗6周后使用阳性和阴性症状量表(PANSS)评定,阴性症状量表分≥20分78人,被随机分为小剂量氨磺必利联合利培酮治疗组(联用组)和利培酮治疗组(对照组)。于基线和治疗8周后评定PANSS量表、卡尔加精神分裂症抑郁量表(CDSS)评定临床疗效,Simpson锥体外系副反应评定量表(SEPS)评定锥体外系副反应。结果治疗8周后两组有效率分别为94.6%和77.8%,差异有统计学意义(χ2=4.365,P=0.037),实验组PANSS阴性量表减分(P=0.000)、CDSS减分(P=0.019)大于对照组,差异有统计学意义,两组SEPS无明显差异。结论小剂量氨磺必利联合利培酮治疗精神分裂症阴性症状疗效更好。

Objective To compare the effectiveness of the negative symptoms of first：episode Schizophrenia patients treated with low-dose amisulpride combined risperidone or risperidone. Methods A total of 78 schizophrenic in-patients who had maintained on oral risperidone for 6 weeks,in the meanwhile Negative Symptoms Scale≥20 were randomly divided into two groups which were treated with low-dose amisulpride combined risperidone（experimental group）and oral risperidone（controls）. Patients received of ei- ther low-dose amisulpride（100~ 300 mg/day）and risperidone（4~ 6 mg/day）or risperidone（4~ 6 mg/day）for 8 weeks. Positive And Negative Symptoms Scale （PANSS）, Calgary Depression Scale for Schizophrenia （CDSS）, Simpson Extrapyramidal Scale （SEPS） were used to evaluate the clinical efficacy and extrapyramidal side effects at the baseline and the end point. Results At the end of the trial,effeetive rates of the two groups were 94. 6% and 77.8% respectively,and had significant difference （Z2= 4. 365 ,P= 0. 037）. Compared to risperidone ,the experimental group had more reduction in the PANSS negative subseale score（P= 0. 000 ）and the CDSS score （P = 0. 019）,and no significant difference of SEPS （P = 0. 247）. Conclusion Low-dose amisulpride combined risperidone is more effective in treating negative symptoms of first-episode schizophrenia patients.