MECT联合氨磺必利治疗精神分裂症阴性症状的对照研究

A control study of amisulpride combined with MECT in the treatment of negative symptoms of schizophrenia patients

目的探讨无抽搐电休克(MECT)联合氨磺必利与单用氨磺必利治疗精神分裂症阴性症状的疗效及安全性。方法将80例阴性症状为主的精神分裂症患者分为无抽搐电休克联合氨磺必利治疗组(联合组)和单用氨磺必利治疗组(单用组),每组均40例,疗程为8周,采用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评定疗效,韦氏记忆量表(Wechsler Memory Scale,WMS)评定记忆状况以及不良反应量表(Treatment Emergent Symptom Scale,TESS)评定不良反应。结果第8周末,联合组治疗有效率显著高于单用组有效率(87.5%vs 67.5%,P<0.05);联合组PANSS总分及阴性因子评分(分别为46.7±14.2,18.4±6.0)低于单用组(分别为55.2±13.9,22.9±6.4),差异具有统计学意义(t=2.66、3.69,P均<0.01),TESS评分无统计学差异;第8周末联合组韦氏记忆量表的图片、再认、背数记忆及联想4个因子与本组治疗前相比无明显差异(P>0.05)。结论无抽搐电休克联合氨磺必利治疗精神分裂症的阴性症状疗效显著,优于单用氨磺必利治疗,起效快,安全可靠,对记忆影响是短暂而可逆的。

Objective To investigate the efficacy and safety of amisulpride combined with MECT and amisulpride respectively in the treatment of negative symptoms of schizophrenia patients .Methods 80 schizophrenia patients with predominant negative symptoms were divided into the combined group （ amisulpride combined with MECT） and the control group （amisulpride only）, each group had 40 patients.The efficacy was assessed by PANSS （ Positive and Negative Syndrome Scale ） , memory states and side effects were assessed by WMS （ Wechsler Memory Scale ） and TESS （ Treatment Emergent Symptom Scale ） .Results After 8-week treatment, the response rate of the combined group was higher than the control group （87.5% vs.67.5%,P〈0.05）, the combined patients scored less in PANSS score and negative factor score than the control group （separately 46.7 ±14.2 vs.55.2 ±13.9, 18.4 ±6.0 vs.22.9 ±6.4, t=2.66、3.69, all P〈0.01）, no significant difference were found in TESS score between the two groups .In the combined group , no statistical difference were found in picture factor , recognition factor , number memory factor and association factor of WMS （all P〉0.05） between before-and after-8-week treatment.Conclusions The efficacy of MECT combined with amisulpride is better than the single use of amisulpride in the treatment of negative symptoms of schizophrenia .