利培酮联合舍曲林治疗精神分裂症强迫症状的疗效观察

Observation of the Efficacy of Risperidone Combined with Sertraline in the Treatment of Schizophrenia with Obsessive-compulsive Symptoms

目的:观察利培酮联合舍曲林治疗精神分裂症患者伴强迫症状的临床疗效与安全性。方法:60例精神分裂症伴强迫症状住院患者随机分为两组,每组30例。两组均口服利培酮片治疗,观察组联合舍曲林片治疗,观察8周。分别于治疗前及治疗期间采用阳性与阴性症状量表评定精神症状,Yale-Brown强迫症状量表评定强迫症状,副反应量表评定不良反应。结果:治疗后两组改善精神症状总有效率比较,差异无统计学意义(P>0.05),但观察组改善强迫症状总有效率显著高于对照组(P<0.01)。治疗后第4,8周末,观察组PANSS总分、Y-BOCS总分、强迫思维维度分、强迫行为维度分等均较治疗前显著下降(P<0.05或(P<0.01);对照组第4,8周末PANSS总分、Y-BOCS总分、强迫思维维度分较治疗前显著下降(P<0.05或(P<0.01),第8周末,强迫行为维度分也较治疗前显著下降(P<0.05)。且治疗后,两组Y-BOCS总分、强迫思维维度分、强迫行为维度分比较,差异有统计学意义(P<0.05或(P<0.01)。两组8周末时TESS评分比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:利培酮联合舍曲林治疗精神分裂症患者伴强迫症状疗效显著,安全性好,优于单用利培酮治疗。

Objective：To observe the clinical efficacy and safety of risperidone combined sertraline in the treat- ment of patients with schizophrenia with obsessive-compulsive symptoms. Methods： 60 patients of schizophrenia with ob- sessive-compulsion symptoms were randomly divided into two groups, 30 cases in each group. The control group are treated with risperidone tablets oral therapy, the observation group with treated with sertraline on the basic of the control group, two groups were observed 8 weeks. The positive and negative symptoms scale were used to assess mental symptoms, Yale-Brown obsessional-compulsive symptoms scale were used to evaluate forced symptoms, side effects scale were used to assess ad- verse reactions respectively before and during treatment. Results： After treatment, the total efficiency rate of psychiatric symptoms improvement on the two groups had no significant difference （P 〉 0.05 ）, but the total effective rate of forced symptoms improvement on observation group was significantly higher than control group （P 〈 0.01 ）. Treatment after the 4 and 8 weekend, the observation group, total score of PANSS, Y-BOCS score, forced thinking dimension, compulsive be- havior dimension classification than before treatment was significantly decreased （P 〈 0.05 or P 〈 0.01 ） ; control group at 4 and 8 weekend PANSS total score, scores of Y-BOCS, forced thinking dimensions were randomly assigned to treatment significantly decreased （P 〈 0.05 or P 〈 0.01 ） , at the end of the 8th week, forcing behavior dimension points compared with before treatment, decreased significantly （ P 〈 0.05 ）. After treatment, the total score of Y-BOCS, obsessive compul- sive thinking and compulsive behavior were statistically significant （ P 〈 0.05 or 0.01 ）. The scores of TESS in the 8 groups at the weekend of two were not statistically significant （P 〉 0.05 ）. There was no significant difference on the incidence of adverse reactions between two groups （P 〉 0.05 ）. Conclusion： Risperidone combined sertraline in the treatment of schizo- phrenia patients with obsessive-compulsive symptoms has significant effect and high safety, significantly better than that of ristaeridone therapy only.