奥氮平合并丙戊酸镁缓释片治疗伴攻击行为的男性精神分裂症临床观察

Clinical observation of olanzapine combined sustained-release magnesium valproate tablet treating male schizophrenic patients with aggressive behavior

目的:观察奥氮平联合丙戊酸镁缓释片治疗伴攻击行为的男性精神分裂症患者的疗效及安全性。方法:将75例伴有攻击行为的男性精神分裂症患者随机分为奥氮平联合丙戊酸镁缓释片组(合用药组,37例)和单用奥氮平组(单用药组,38例)进行6周的观察。于治疗前及治疗1、2、4、6周分别采用修订版外显攻击行为量表(MOAS)、阳性症状量表(SAPS)和阴性症状症状量表(SANS)评定疗效,治疗6周采用治疗中出现的症状量表(TESS)评定不良反应。结果:重复测量方差分析显示,MOAS总分、SAPS评分两组间有明显统计学意义(F=3.725,P=0.016;F=1.677,P=0.024);MOAS总分和SAPS评分合用药组显著低于单用药组。两组MOAS总分、SAPS、SANS评分均具有时间效应(F=28.314,F=12.417,F=5.362;P均<0.01),但治疗效应与时间效应均无交互作用(F=2.937,P=0.065;F=4.831,P=0.272;F=2.619,P=0.481)。两组不良反应发生率差异无统计学意义。结论:奥氮平联合丙戊酸镁缓释片对伴攻击行为男性精神分裂症患者的疗效优于单用奥氮平,且起效快、安全性好。

Objective：To observe the efficacy and safety of olanzapine combining sustained-release mag nesium valproate tablet in the treatment of male schizophrenic patients with aggressive behavior. Method： Seventy-five male schizophrenic patients with aggressive behavior were randomly divided into olanzapine combi- ning sustained-release magnesium valproate tablet group （ combined treatment group, n = 37 ） and olanzapine group （single drug group, n = 38）for 6 weeks observation. Modified overt aggression scale （MOAS）, scale for as sessment of positive symptoms （SAPS） negative symptoms （SANS） were used to assess the efficacy at the base- line and the end of 1,2,4,6 weeks. Treatment emergent symptom scale（TESS） was also used for assessing the adverse reactions at the end of 6 weeks. Results： Repeated measure variance analysis showed significance difference on scores of MOAS and SAPS between the two groups （ F = 3. 725, P = 0. 016 ; F = 1. 677, P =0.024）. The scores of MOAS and SAPS in combined treatment group were lower than those in single drug group. Moreover,the scores of MOAS, SAPS and SANS of both groups shown time effects （ F = 28. 314, F = 12. 417, F = 5. 362, all P 〈 0. 01 ） while no interaction between treatment effects and time effects （ F = 2. 937 ,P = 0. 065 ; F = 4. 831, P = 0. 272 ; F = 2. 619, P = 0. 481 ）. There were no significant difference between the two groups in adverse reactions. Conclusion：Olanzapine combining sustained-release magnesium valproate tablet may be more effective, faster and safer than single olanzapine in the treatment of male schizophrenic patients with aggressive behavior.