丙戊酸钠片联合盐酸文拉法辛缓释片治疗女性精神分裂症合并情感障碍的效果观察

Effect of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in the treatment of female schizophrenia with affective disorder

目的 探讨丙戊酸钠片联合盐酸文拉法辛缓释片在女性精神分裂症合并情感障碍患者中的临床效果及对患者复发时间的影响.方法 选择2013年1月至2016年7月太原市精神病医院收治的女性精神分裂症合并情感障碍患者98例,采用随机数字表法分为单一用药组（49例）和联合用药组（49例）.单一用药组采用盐酸文拉法辛缓释片治疗,联合用药组在单一用药组基础上加用丙戊酸钠片治疗,比较两组临床疗效以及复发情况.结果 联合用药组治疗后1个月戒断症状[（4.39±0.94）分]、阳性症状[（11.55±4.30）分]、阴性症状[（11.09±1.21）分]及精神病理症状评分[（12.01±2.16）分],均低于单一用药组戒断症状[（10.98±1.43）分]、阳性症状[（16.74±3.89）分]、阴性症状[（18.43±2.05）分]及精神病理症状评分[（19.83±3.44）分]（t=12.957、18.471、11.498、15.893,均P＜0.05）;联合用药组治疗后电位P300的潜伏期[（314.55 ±9.21）s]和波幅[（4.05±1.76）s],均高于单一用药组电位P300的潜伏期[（341.60 ±25.87）s]和波幅[（2.58±2.30）s]（t=18.251、15.738,均P＜0.05）;联合用药组手治疗后12周眼动测定水平分别为（27.30±1.41）s和（6.15 ±0.98）s,均高于单一用药组[（25.10±2.93）s和5.10±1.20）s]（t=13.992、15.836,均P＜0.05）;联合用药组治疗后复发率为8.16％,低于单一用药组的18.37％（x2=6.893,P＜0.05）;联合用药组住院时间[（14.83±4.61）d]、症状改善时间[（34.94±7.85）d],短于单一用药组住院时间[（27.91±7.49）d]、症状改善时间[（59.81±10.94）d]（t=18.946、21.461,均P＜0.05）;联合用药组治疗后12周复发时间[（148.48 ±33.19）d],长于单一用药组[（109.46 ±28.88）d]（t=16.893,P＜0.05）.结论 丙戊酸钠片联合盐酸文拉法辛缓释片治疗女性精神分裂症合并情感障碍有助于提高临床效果,延长复发时间,改善患者认知功能,值得推广应用.

Objective To investigate the clinical effect of sodium valproate tablets combined with venlafaxine hydrochloride sustained-release tablets in female patients with schizophrenia complicated with affective disorders and its influence on the recurrence time.Methods From January 2013 to July 2016,98 female patients with schizophrenia complicated by affective disorder in Taiyuan Mental Hospital were selected and randomly divided into single group （n =49） and combination group （n =49） according to the digital table.The single drug group was treated with sodium valproate tablets,and the combination group was treated with venlafaxine hydrochloride sustained-release tablets on the basis of a single drug group.The clinical efficacy and recurrence time of the two groups were compared.Results The scores of withdrawal symptoms [（4.39 ± 0.94） points],positive symptoms [（11.55 ± 4.30） points],negative symptoms [（11.09 ± 1.21） points] and psychiatric symptoms [（12.01 ±2.16） points] in the combination group were all significantly lower than those at 1 month after treatment[（10.98 ±1.43） points,（16.74 ± 3.89） points,（18.43 ± 2.05） points,（19.83 ± 3.44） points] （t =12.957,18.471,all P 〈0.05）.The incubation period and amplitude of the P300 potentials in the combination group were （314.55 ± 9.21） s,（4.05 ± 1.76）s,respectively,which were both higher than those of the single drug group [（341.60 ± 25.87）s,（2.58 ± 2.30）s] （t =18.251,15.738,all P 〈 0.05）.The eye movements of the combination group 12 weeks after operaion were （27.30 ± 1.41） s and （6.15 ± 0.98） s,respectively,which were higher than those of the single drug group[（25.10 ± 2.93） s and （5.10 ± 1.20） s] （t =13.992,15.836,all P 〈 0.05）.The recurrence rate of the combined group was 8.16%,which was lower than 18.37% of the single drug group（x2 =6.893,P 〈 0.05）.The hospitalization duration [（14.83 ± 4.61）d],symptom improvement time [（34.94 ± 7.85）d] of the combined group were shorter than those of the single drug group [（27.91 ± 7.49） d,（59.81 ± 10.94） d] （t =18.946,21.461,all P 〈 0.05）.The recurrence time at 12 weeks after treatment of the combination group was （148.48 ± 33.19）d,which was longer than （109.46 ±28.88）d of the single drug group（t =16.893,P 〈0.05）.Conclusion The combination of sodium valproate tablets and venlafaxine hydrochloride sustained-release tablets in.patients with schizophrenia complicated with affective disorders can improve the clinical effect,shorten the recurrence time and improve the cognitive function of patients,which is worth popularizing and applying.