长期氯氮平治疗慢性精神分裂症患者合并喹硫平后的疗效分析

The Analysis of the Therapeutic Effect of combine Quetiapine in the Chronic Schizophrenia Patients with Long Term Clozapine Treatment

目的比较长期氯氮平治疗慢性精神分裂症患者合并喹硫平后的疗效及不良反应。方法将氯氮平以0~25 mg/d的速度递减,1周后合并使用喹硫平。喹硫平起始剂量为50 mg/d,氯氮平起始剂量为75~150 mg/d,后面根据患者个体情况调整药物剂量,观察16周。喹硫平治疗剂量为200~450 mg/d,平均为(324±116)mg/d,氯氮平治疗剂量为100~200 mg/d,平均(126±45)mg/d。结果联合应用喹硫平,治疗前、治疗后PANSS阳性分量表分、阴性分量表分以及总分分别比较其差异有统计学意义(P<0.05)。在治疗第8、16周PANSS总分较治疗前显著降低(P<0.05)。治疗后TESS部分评分较治疗前显著减少。结论喹硫平合并氯氮平疗效肯定,不良反应较轻,值得在临床上推广应用。

Objective Comparing the therapeutic effect and the side effects after replacing quetiapine in the patients with chronic schizophrenia under clozapine treatment.Methods Combine treatment of quetiapine was started 1 week after clozapine dose was reduced with 0-25 mg/d.The initial dose of quetiapine was 50 mg/d,and the clozapine dose was 75-150 mg/d.Then both doses were adjusted according to the individual condition,and the patients were observed for 16 weeks.Quetiapine therapeutic dose was 200-450 mg/d,average(324±116)mg/d;Clozapine therapeutic dose was 100-200 mg/d,average(126±45)mg/d.Results Comparing the score of pre&post the combination therapy,the PANSS,the SAPS and the SANS differences had statistic significancy(P<0.05).The 8th and 16th week PANSS score reduced significantly(P<0.05),comparing with pre-combination therapy.Partial score of TESS reduced significantly comparing with pre-combination therapy.Conclusion Combination treatment of quetiapine and clozapine in chronic schizophrenia patients had positive therapeutic effect and had only mild side effect.Clinical promotion is recommended.