利培酮在慢性精神分裂症患者治疗中与氯氮平合并使用的疗效观察

Curative effect observation of Risperidone combined with Clozapine in treatment of chronic schizophrenia

目的:观察长期住院服用氯氮平治疗的慢性精神分裂症患者合用利培酮治疗后的疗效及不良反应。方法:对40例长期住院并服用氯氮平治疗的慢性精神分裂症患者联合使用利培酮治疗,治疗前,治疗后4、8、12周末,采用阳性症状和阴性症状量表(PANSS)进行疗效评定,采用不良反应量表(TESS)、锥体外系症状评定量表(ESRS)及有关实验室检查记录对患者药物不良反应例数。结果:联合使用利培酮后患者的治疗有效率为22.5%,治疗前后PANSS量表总分、阳性量表分、一般精神病理量表分差异有统计学意义(P<0.05),PANSS量表阴性量表分差异无统计学意义(P>0.05),治疗后患者的不良反应例数减少。结论:对于长期住院服用氯氮平的患者,氯氮平和利培酮联用对患者的阳性症状及一般精神病理症状能有所改善,对阴性症状改善不明显,总体有效率不高,但能减少氯氮平使用剂量,降低不良反应的发生率。

Objective：To observe curative effects and adverse reactions of Risperidone combined with Clozapine in treatment of long-term hospitalization chronic schizophrenics, who had taken Clozapine for a long time. Methods：40 long-term hospitalization chronic schizophrenics took Risperidone based on Clozapine. Before and 4, 8, and 12 weeks after the treatment, positive and negative syndrome scale （PANSS） was applied for the evaluation of curative effects; treatment emergent symptom scale （TESS）, Extrapyramid-al symptom rating scale （ESRS）, as well as the relevant laboratory examination record of the number of cases were used to access the adverse drug reactions. Results： The effective rate of Risperidone combined with Clozapine was 22. 5% . There were statistical differ-ences in the PANSS total score, positive symptom scale score, and general psychopathology scale score before and after the treatment （P〈0. 05）, however, there was no statistical difference in the negative symptom scale score before and after the treatment （P〉0. 05）. After the treatment, the number of the cases of the adverse reactions decreased. Conclusions： For the long-term hospitalization chronic schizophrenics, Risperidone combined with Clozapine can improve the positive symptoms and general psychopathological symptoms, but can not improve the negative symptoms. Although Risperidone combined with Clozapine does not have a high total effective rate, it can reduce the dosage of Clozapine and decrease the occurrence rate of the adverse reactions.