氯氮平治疗难治性精神分裂症的优化治疗探讨

Study on Optimized Treatment of Clozapine in Treatment of Treatment-resistant Schizophrenia

目的该文将对氯氮平治疗难治性精神分裂症的优化治疗进行探讨,使其有效提升患者生活质量。方法选取2014年12月—2017年12月该院收治的40例难治性精神分裂症患者作为此次实验研究对象,随机分为对照组与观察组。对照组患者给予氯氮平进行治疗,观察组患者给予小剂量氯氮平并配合利培酮口腔崩片进行治疗。对比两组患者临床治疗疗效。结果治疗前,两组患者各项PANSS评分差异无统计学意义(P>0.05);治疗后,两组患者PANSS评分均有所下降,观察组总分2周(73.45±2.85)分、4周(62.56±2.63)分、8周(49.35±2.35)分下降程度明显大于对照组总分2周(79.18±3.11)分、4周(70.23±3.62)分、8周(58.25±2.84)分(t=5.26、8.552、10.248,P<0.05.);观察组患者不良反应发生率20%明显低于对照组65%,两组数据差异有统计学意义(χ~2=6.043,P<0.01)。结论在探讨氯氮平治疗难治性精神分裂症的优化治疗方式中,使用小剂量氯氮平与利培酮口腔崩片进行联合,临床治疗效果显著,有效改善患者症状,不良反应少,提升患者生活质量,临床需要广泛推广及应用。

Objective To study the optimized treatment of clozapine in treatment of treatment-resistant schizophrenia thus effectively improving the quality of life. Methods 40 cases of patients with treatment-resistant schizophrenia admitted and treated in our hospital from December 2014 to December 2017 were selected and randomly divided into two groups, the control group were treated with clozapine, while the observation group were treated with small-dose clozapine and risperidone oral disintegrating tablets, and the clinical treatment curative effect was compared between the two groups. Results Before treatment, the differences in the PANSS scores between the two groups were not obvious（P 0.05）, after treatment, the PANSS scores of the two groups decreased, and the total scores in 2 weeks, 4 weeks and 8 weeks in the observation group were obviously higher than those in the control group [（73.45 ±2.85）points,（62.56±2.63）points,（49.35 ±2.35）points vs（79.18 ±3.11）points,（70.23 ±3.62）points,（58.25 ±2.84）points（t =5.26, 8.552, 10.248,P 0.05.）], and the incidence rate of adverse reactions in the observation group was obviously lower than that in the control group（20% vs 65%）, and the differences between groups were obvious（χ2=6.043,P0.01）. Conclusion The smalldose clozapine and risperidone oral disintegrating tablets in the optimized treatment of treatment-resistant schizophrenia has an obvius clinical treatment effect, which can effectively improve the symptoms with few adverse reactions and improve the quality of life of patients, and it can be widely promoted and applied in clinic.