无抽搐电休克联合氯氮平治疗难治性精神分裂症临床观察

Clinical observation of MECT combined with clozapine for refractory schizophrenia

目的探讨无抽搐电休克(MECT)联合氯氮平对难治性精神分裂症的临床疗效。方法选取符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)难治性精神分裂症断标准的患者91例,采用随机数字表法分为观察组(n=46)和对照组(n=45),给予对照组单纯氯氮平25mg,每天睡前服用,观察组在此基础上接受MECT治疗。于治疗前后采用阳性和阴性症状量表(PANSS)评定临床疗效,采用症状量表(TESS)评定不良反应。结果治疗12周后,观察组和对照组总有效率比较差异有统计学意义(91.3%vs.71.1%,P<0.05);观察组治疗后的PANSS总评分为(32.7±3.8)分,不良反应发生率为15.2%,低于对照组的(56.6±4.5)分和37.8%,差异有统计学意义(P<0.05)。结论 MECT联合氯氮平对难治性精神分裂症疗效和安全性均优于单用氯氮平。

Objective To explore the clinical effect of Modified Electric Convulsive therapy( MECT) combined with clozapine for refractory schizophrenia. Methods 91 patients who met the diagnose of CCMD- 3 with refractory schizophrenia were divided into the observation group( n = 46) and the control group( n = 45). The control group were given clozapine with 25 mg before going to bed every day while giving Observation group both medicine treatment( the same as control group) and MECT treatment. Applying positive and negative syndrome scale( PANSS) for clinical efficacy and Symptom scale( TESS) for adverse reactions in patients before and after the treatment. Results After 12 weeks of treatment,the total effective rate between the observation group and the control group were statistically significant( 91. 3% vs. 1. 1%,P < 0. 05). The PANSS score of the observation group( 32. 7 ± 3. 8) and the incidence of adverse reactions( 15. 2%) was significantly lower than the control group( 56. 6 ± 4. 5) points and 40. 0%,the differences were statistically significant( P < 0. 05). Conclusion MECT combined with clozapine treated on refractory schizophrenia is more effective and safer than clozapine therapy.