奥氮平联合小剂量氨磺必利治疗慢性精神分裂症阴性症状对照研究

A control study of olanzapine combined with small dose of amisulpride in the treatment of negative symptoms of chronic schizophrenia

目的：探讨奥氮平合并小剂量的氨磺必利治疗慢性精神分裂症患者的疗效和安全性。方法将60例慢性精神分裂症患者按随机数字表法分为A组和B组各30例；A组采用奥氮平联合小剂量氨磺必利治疗，对照组单用奥氮平治疗，观察12周。治疗前后采用阳性与阴性症状量表评定临床疗效，副反应量表评定不良反应。结果治疗4周末起两组阳性与阴性症状量表总分及各因子评分均较治疗前显著下降（ P＜0．05或0．01），A组治疗8周、12周末总分及阳性症状、阴性症状因子评分均显著低于对照组（ P＜0．05）；治疗12周末A组总有效率为80．0％，B组为73．3％，两组总有效率比较差异无显著性（ P＞0．05）。两组不良反应较轻微，A组体质量增加发生率显著低于B组（P＜0．05），其他不良反应发生率两组比较差异均无显著性（P＞0．05）。结论奥氮平联合小剂量氨磺必利治疗慢性精神分裂症患者疗效显著，特别是在改善阴性症状方面具有显著优势，且不增加不良反应，安全性高，优于单用奥氮平治疗。

Objective To explore the efficacy and safety of olanzapine combined with small dose of amisul‐pride in the treatment of negative symptoms of chronic schizophrenia .Methods Sixty chronic schizophren‐ics were randomly divided into group A and B of 30 ones each ;groups A was treated with olanzapine com‐bined with small dose of amisulpride and B with single olanzapine for 8 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS） before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale （TESS） .Results Since the end of the 4th week the total and all factors scores of both groups lowered more significantly compared with pretreatment （ P〈 0 .05 or 0 .01） ,the total ,positive and negative symptoms scores were significantly lower in group A than in B at the ends of the 8th and 12th week （P〈0 .05）;at the end of the 12th week the total effective rate was respec‐tively 80 .0% in group A and 73 .3% in B ,which showed no significant group difference （P〉0 .05） .Ad‐verse reactions of both groups were mild ,the incidence of weight gain was significantly lower in group A than in B （P〈0 .05） ,and there were no significant group differences in the incidences of other adverse re‐actions （P〉0 .05） .Conclusion Olanzapine combined with small dose of amisulpride has an evident effect in the treatment of chronic schizophrenia ,especially in improving negative symptoms ,doesn’t increase ad‐verse reactions ,and has higher safety compared with single olanzapine .