阿美戈拉汀合并利培酮治疗以阴性症状为主的慢性精神分裂症的临床研究

A Clinical Study of Agomelatine Combined with Risperidone in the Treatment of Chronic Schizophrenia with Negative Symptoms

目的:探讨阿美戈拉汀合并利培酮治疗慢性精神分裂症患者(以阴性症状为主)的疗效,同时对比治疗前后的生存质量和主观幸福感。方法:采用随机单盲对照研究,将明确诊断且连续收集的为以阴性症状为主的102例精神分裂症患者随机分为研究组(利培酮合并阿美戈拉汀治疗,52例)和对照组(单用利培酮治疗,50例);用阴性症状量表(SANS)判定疗效;用WHO生存质量测定量表简表(WHOQOL-BREF)判定生存质量;人际反应指针量表(IRI-C)评定患者的共情能力;用药物副作用(TESS)判定治疗中的不良反应,治疗随访8周。结果:两组治疗前基线信息无统计学差异。治疗8周后,研究组疗效(87.23%)显著高于对照组(66.67%)(χ~2=5.65,P<0.05);研究组在SANS总分、情感迟钝、抽象思维障碍、刻板思维因子分改善程度优于对照组(t=-7.6127,-2.1017,-2.4293,-6.4975;P<0.05);WHOQOL-BREF量表研究组在生理领域、心理领域、社会关系领域均较对照组有统计学差异(t=6.3395,11.7905,3.9233;P<0.05);研究组IRI-C量表在总分、观点选择、共情性关心、个人痛苦维度均较对照组改善明显(t=2.1860,3.9076,2.8223;P<0.05);两组药物副作用发生率差异无统计学意义。结论:利培酮合并阿美戈拉汀对精神分裂症阴性症状疗效好,能明显提高患者的生存质量和主观幸福感,具有较好的临床应用价值。

Objective： To evaluate the effect of risperidone combined with agomelatine on the quality of life and sense of well--being of patients with chronic schizophrenia.Methods：Using randomized single blind controlled study, 102 cases of patients with a clear diagnosis of mainly with negative symptoms of senile schizophrenia were randomly divided into research group（52 cases with risperidone and agomelatine）and treatment group（50 cases with only ris- peridone）.SANS was used to assess therapeutic efficiency, the Interpersonal Reactivity index-c（IRI--C）to evaluate the patient＇s empathy ability, the Philadelphia＇Geriatric Center（PGC）confidence scale for assessment of subjective well--being, the side effect scale（TESS） to assess adverse drug reactions.Results：There was no significant differences between the two groups before treatment （P ：〉 0.05）. After 8 weeks of treatment, the clinical efficacy of the study group and the control group were respectively 86.67%,66.67% （X^2 =5.65,P〈0.05）.In the study group,the scores of SANS total score, emotional retardation, abstract thinking disorder and stereotyped thinking factors were better than those of the control group（t =-7.5127, 2.1017,-2.4293,-6.4975;P〈0.05）.WHOQOL--BREF scale showed that the study group in the physiological field, psychological field, social relations was significant different with the control group（t=6.3395,11.7905,3.9233;P〈O.O5）;The study group in the IRI-C score,view selection,empathic concern and personal distress dimensions was significant different with the eontrol group（t=2.1860,3.9076,2.8223, P〈0.06）.Conclusion：Risperidone combined with agomelatine has a good effect on negative symptoms of schizophre nia,and can significantly improve the patient＇s quality of life.