舒必利联合奥氮平治疗难治性精神分裂症的疗效观察

Clinical observation on sulpiride combined with olanzapine in treatment of refractory schizophrenia

目的观察舒必利片联合奥氮平片治疗难治性精神分裂症的疗效情况。方法选取2017年6月-2018年7月上海市精神卫生中心治疗的81例难治性精神分裂症患者作为研究对象。根据患者就诊时间的差异,将患者分为对照组(33例)和观察组(48例)对照组患者口服奥氮平片,初始用药剂量为10 mg/次,1次/d。用药剂量在1周内逐渐增至20 mg/次,1次/d。观察组在对照组的基础上口服舒必利片,舒必利片初始用药剂量为100 mg/次,2次/d。用药剂量在1周内逐渐增至300 mg/次,2次/d。两组患者均接受连续3个月的药物治疗。观察两组患者的临床疗效和不良反应发生情况,同时比较两组治疗前后的阳性、阴性症状量表(PANSS)评分、威斯康星卡片分类检测(WCST)评分。结果治疗后,观察组和对照组的治疗总有效率分别为93.75%、69.70%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者PANSS评分均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);观察组PANSS评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者持续、非持续错误数评分均显著降低,完成分类数、总正确数评分均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,观察组WCST各维度评分均明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗期间,对照组不良反应发生率为36.36%,与观察组31.25%比较无明显差异。结论舒必利片联合奥氮平片可以有效改善难治性精神分裂症患者的认知功能,且安全性较高,具有广阔的应用前景,值得进行推广应用。

Objective To observe the efficacy of Sulpiride Tablets combined with Olanzapine Tablets in treatment of refractory schizophrenia.Methods Patients(81 cases)with refractory schizophrenia in Shanghai Mental Health Center from June 2017 to July2018 were included in this study.According to the difference in hospital admission time,patients were devided into control group(33 cases)and observation group(48 cases).Patients in the control group were po administered with Olanzapine Tablets,the initial dose was 10 mg/time,once daily,and the dosage was gradually increased to 20 mg/time,and once daily within 1 week.Patients in the observation group were po administered with Sulpiride Tablets on the basis of control group,the initial dose of Sulpiride Tablets was 100 mg/time,twice daily,and gradually increased to 300 mg/time,twice daily within 1 week.Patients in two groups were treated for 3 months.The clinical efficacy and adverse reactions in two groups were observed,and the PANSS score and WCST score before and after treatment were compared.Results After treatment,the total effective rate of treatment in the observation group and the control group was 93.75%and 69.70%,respectively,the difference between two groups was statistically significant(P<0.05).After treatment,PANSS scores in two groups were significantly decreased,and the difference before and after treatment in the same group was statistically significant(P<0.05).And the PANSS score in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).After treatment,the scores of persistent and non-persistent errors number in two groups were significantly decreased,and the scores of completed classifications number and the total number of correct scores were significantly increased,the differences before and after treatment in the same group were statistically significant(P<0.05).After treatment,the WCST scores of each dimension in the observation group were significantly better than those in the control group,and the difference between two groups was statistically significant(P<0.05).During the treatment,the incidence of adverse reactions in the control group was 36.36%,with no significant difference compared with 31.25%in the observation group.Conclusion Sulpiride Tablets combined with Olanzapine Tablets can effectively improve the cognitive function of patients with refractory schizophrenia,and the safety is high,it has broad application prospect and is worth popularizing.