丙戊酸镁联合治疗伴攻击行为的精神分裂症的疗效及安全性

Efficacy and safety of magnesium valproate in the treatment of schizophrenia with aggressive behavior

目的探讨丙戊酸镁对伴攻击行为的精神分裂症患者的疗效及安全性。方法选取我院于2014年4月～2017年6月期间收治的64例伴攻击行为的精神分裂症患者,按照随机数字表法将所有患者随机均分为对照组和试验组两组。其中对照组患者均服用奥氮平进行常规治疗,而试验组患者则在对照组的治疗基础上联合使用丙戊酸镁进行治疗。分析两组患者治疗前后的精神症状评分和外显行为攻击评分、副反应量表评分等评分情况,比较两组患者的不良反应发生情况。结果对照组患者的外显攻击行为量表评分(Modified Overt Aggression Scale,MOAS)和精神症状评分(Teaching Psychiatric Rating Scale,TPRS)在治疗2周后才有所改善,而试验组患者的MOAS评分和TPRS评分在治疗1周后即开始有所改善,并且治疗1周后直至治疗4周后,试验组患者的MOAS评分和TPRS评分均显著低于对照组患者(均P<0.05)。对照组患者治疗2周后和治疗4周后的TESS评分均显著高于试验组患者(t=2.235,t=2.783,均P<0.05)。试验组患者的不良反应发生率为9.38%,显著低于对照组患者的34.38%(χ2=5.938,P<0.05)。结论丙戊酸镁治疗伴攻击行为的精神分裂症能够有效改善患者的外显行为和精神症状,其治疗效果及安全性均较常规治疗有显著提升。

Objective To investigate the efficacy and safety of magnesium valproate in the treatment of schizophrenia with aggressive behavior.Methods According to random number table method,64schizophrenia cases with attack behavior from April 2014 to June 2017 were selected and divided into control group (n=32)and experimental group (n=32).The control group was treated with olanzapine,while the experimental group was treated with magnesium valproate in combination with the treatment of the control group.The efficacy and the adverse reactions in the two groups of patients before and after treatment were analyzed.Results The MOAS score and TPRS score in the control patients at 2weeks after treatment was improved,while those in the experimental group patients began to improve after 1 week of treatment.The MOAS score and TPRS scores in the experimental group were significantly lower than those in the control group after 1and 4weeks of treatment (P<0.05).The TESS score of the control group after 2 weeks and after 4 weeks was significantly higher than that in the experimental group (t=2.235,t=2.783,all P<0.05).The incidence of adverse reactions was 9.38%in the experimental group,which significantly lower than in the control group (34.38%)(X^2=5-938,P<0.05).Conclusion The magnesium valproate can effectively improve the patient's explicit behavioral and psychological symptoms in the schizophrenia patients with aggressive behavior.