氨磺必利联合奥氮平改善精神分裂症患者认知功能的疗效观察

Clinical observation of amisulpride combined with olanzapine in improvement of cognitive function in patients with schizophrenia

目的观察氨磺必利联合奥氮平改善精神分裂症患者认知功能的临床疗效。方法将2013年10月—2015年10月在上海市宝山区精神卫生中心住院的精神分裂症患者61例随机分为对照组（31例）和治疗组（30例）,对照组口服奥氮平片,起始剂量10 mg/d,依患者病情及症状,1周内增加至15～20 mg/d,平均给药剂量（18.75±1.13）mg/d;治疗组在对照组基础上口服氨磺必利片,起始剂量0.1 g/d,根据具体病情,1周内增加至0.1～0.3 g/d,平均给药剂量（0.26±0.06）g/d。两组均连续治疗8周。比较两组治疗前后的阳性症状与阴性症状量表（PANSS）、韦氏记忆量表（WMS）、威斯康星卡片分类测验（WCST）评定。结果治疗4周后,两组的阳性症状评分、一般精神病理症状评分和总分较治疗前均显著改善（P〈0.05、0.01）;且治疗组阴性症状分值和总分改善程度明显优于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗8周后,两组的阳性症状评分、阴性症状评分、一般精神病理症状评分和总分均较治疗前显著改善,同组治疗前后差异有统计学意义（P〈0.05）。两组治疗后比较差异无统计学意义。治疗8周后,两组的正确数、完成分类数显著升高,随机错误数显著降低,两组比较差异具有统计学意义（P〈0.05）;且治疗组的WCST评分改善程度明显优于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗8周后,两组的WMS评分差异无统计学意义。结论氨磺必利联合奥氮平能够显著改善精神分裂症患者的认知功能,具有一定的临床推广应用价值。

Objective To observe the clinical effects of amisulpride combined with olanzapine in improvement of cognitive function in patients with schizophrenia. Methods Patients（61 cases） with schizophrenia in Mental Health Center of Baoshan District in Shanghai from October 2013 to October 2015 were randomly divided into control group（31 cases） and treatment group（30 cases）. The patients in the control group were po administered with Olanzapine Tablets 10 mg/d at beginning, then gradually added to 15 —20 mg/d according to patient＇s condition and symptoms in one week, and the average dosage was（18.75 ± 1.13） mg/d. Patients in the treatment group were po administered with Amisulpride Tablets 0.1 g/d at beginning, then gradually added to 0.1 — 0.3 g/d according to patient＇s condition in one week, and the average dosage was（0.26 ± 0.06） mg/d. Two groups were treated for 8 weeks. Positive and negative syndrome scale（PANSS）, Wechsler memory scale（WMS）, and Wisconsin card sorting test（WCST） were compared before and after treatment. Results After treatment for 4 weeks, positive symptom scores, general mental pathological symptom scores, and total scores in both groups were improved significantly（P〈 0.05, 0.01）. The negative symptom scores and total scores in the treatment group were significantly better than those in the control group, and there were significant differences between two groups（P〈 0.05）. After treatment for 8 weeks, positive symptom scores, negative symptom scores, general mental pathological symptom scores, and total scores in both groups were improved significantly, and the differences were statistically significant in the same group（P〈 0.05）. There was no significant difference between two groups. After treatment for 8 weeks, the number of correct responses and categories were significantly increased, but the number of random errors was significantly decreased, and the differences were statistically significant in the same group（P〈 0.05）. The WCST scores in the treatment group were significantly better than those in the control group, and there were significant differences between two groups（P〈 0.05）. After treatment for 8 weeks, there was no significant difference between two groups. Conclusion Amisulpride combined with olanzapine has significant clinical curative effect in improvement of cognitive function in patients with schizophrenia, which has a certain clinical application value.