齐拉西酮联合小剂量氯氮平对改善难治性精神分裂症症状及安全性分析

Ziprasidone Combined with Small Dose of Clozapine on the Improvement of the Symptoms of Refractory Schizophrenia and Safety Analysis

目的:探讨齐拉西酮联合小剂量氯氮平对难治性精神分裂症症状的改善作用及其安全性。方法:选取2013年1月-2014年12月就诊于本院的难治性精神分裂症患者80例,按照随机数字表法将其分为对照组和研究组,每组40例。对照组给予氯氮平治疗,研究组给予齐拉西酮和小剂量氯氮平联合治疗,对比两组患者患病症状的改善程度及不良反应发生情况,并在给药后8周进行阳性、阴性症状量表(PANSS)和副反应量表(TESS)评价。结果:经8周后,两组患者治疗后PANSS总分、阳性症状及阴性症状评分均明显低于治疗前,且研究组各项评分均明显低于对照组,差异均有统计学意义(P<0.05)。研究组的治疗总有效率87.5%明显高于对照组的67.5%,差异有统计学意义(字2=4.588,P=0.032)。研究组患者不良反应中的便秘、嗜睡、直立性低血压、心电异常现象和体质量升高的发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论:齐拉西酮联合小剂量氯氮平能明显改善难治性精神分裂症症状,降低不良反应发生率,提高临床安全性,值得临床推广。

Objective：To investigate the improvement effect of Ziprasidone combined with small dose of Clozapine in the symptoms of refractory schizophrenia and its safety.Method：80 patients with refractory schizophrenia admitted to our hospital from January 2013 to December 2014 were selected and divided into the control group and the research group according to the random number table method,40 cases in each group.The control group was treated with Clozapine,the rearch group was given Ziprasidone combined with Clozapine for treatment.The improvement of disease symptoms and adverse reactions between the two groups were compared,and they were evaluated the positive and negative symptom scale（PANSS）and the side reaction scale（TESS）8 weeks after administration.Result：After 8 weeks,the PANSS total score,positive symptoms and negative symptoms score of the two groups after treatment were significantly lower than before treatment,and those of the research group were significantly lower than the control group,the differences were statistically significant（P〈0.05）.The total effective rate of the research group was 87.5%,which was significantly higher than 67.5%of the control group,the difference was statistically significant（χ2=4.588,P=0.032）.The incidence of constipation,drowsiness,orthostatic hypotension,ECG abnormal phenomenon and the increase of body mass in the research group were significantly lower than those in the control group,the differences were statistically significant（P〈0.05）. Conclusion：Ziprasidone combined with small dose of Clozapine can significantly improve the symptoms of refractory schizophrenia,reduce the incidence of adverse reactions,improve the clinical safety,is worthy of clinical promotion.