托吡酯联用奥氮平控制精神分裂症患者攻击行为的研究

Topiramate in combination with olanzapine in the control of aggressive behaviors in patients with schizophrenia

目的：探讨托吡酯联用奥氮平控制精神分裂症患者攻击行为的疗效。方法将60例伴有攻击行为的男性精神分裂症患者分为研究组（32例）和对照组（28例），2组均给予奥氮平及精神科常规护理，在此基础上，研究组加用托吡酯，起始量为25 mg，每3～7 d 增加25～50 mg，渐增至100～200 mg／d。采用修订版外显攻击行为量表（MOAS）和简明精神病评定量表（BPRS）于治疗前及治疗后1、2、3及4周对2组病情各评定1次，比较2组疗效。结果治疗前，研究组 MOAS 和BPRS 总分分别为（21.4±2.5）分、（47.9±12.6）分，对照组分别为（21.5±2.3）分、（48.2±12.3）分，2组比较差异均无统计学意义（P 均＞0.05）。治疗后，2组 MOAS 及 BPRS 总分均低于治疗前（P 均＜0.05）。治疗后4周，研究组 MOAS 和 BPRS 总分分别为（5.5±1.0）分、（23.7±5.4）分，对照组分别为（8.4±1.2）分、（30.7±6.3）分，2组 MOAS 和 BPRS 总分比较差异均有统计学意义（P 均＜0.01）。结论托吡酯联用奥氮平可较好地控制精神分裂症患者的攻击行为。

[Absratct] Objective To explore the therapeutic effect of topiramate in combination with olanzapine in the control of the aggressive behaviors in schizophrenia patients.Methods A total of 60 male schizophrenia patients with aggressive behaviors were divided into a study group （32 patients）and a control group （28 pa-tients）.The patients in both groups were given olanzapine and routine psychiatric care.In addition to these basic treatments,the study group also received topiramate at a starting dose of 25 mg,with an increment of 25-50 mg every 3-7 days until the dose gradually reached 100-200 mg/day.The patients in the two groups were e-valuated before treatment and at one,two,three and four weeks of treatment using the modified overt aggression scale （MOAS）and the brief psychiatric rating scale （BPRS）to compare the drug efficacy in these two groups.Results The MOAS and BPRS scores before treatment were 21.4 ±2.5 and 47.9 ±12.6 in the study group and 21.5 ±2.3 and 48.2 ±12.3 in the control group,respectively,and did not show statistical differences （P〉0.05）.The MOAS and BPRS scores of both groups after treatment were all lower than those before treatment （P 〈0.05）.After four weeks of treatment,the total MOAS and BPRS scores were 5.5 ±1.0 and 23.7 ±5.4 in the study group and 8.4 ±1.2 and 30.7 ±6.3 in the control group,respectively,with statistical differences between the two groups （P 〈0.01）.Conclusion Topiramate in combination with olanzapine can effectively control aggressive behaviors in patients with schizophrenia.