阿立哌唑联合小剂量奥氮平治疗首发精神分裂症的研究

Aripiprazole Combined with Low-dose Olanzapine in the Treatment of First-episode Schizophrenia

目的观察阿立哌唑联合小剂量奥氮平治疗首发精神分裂症的临床疗效。方法选取本医院从2017年10月至2019年4月收治的首发精神分裂症患者92例为研究对象,随机分为对照组和研究组,每组46例。对照组单用阿立哌唑治疗,研究组采用阿立哌唑联合小剂量奥氮平治疗。分别于治疗前及治疗后第2、4、6周的周末用阳性症状和阴性症状量表(PANSS)评价疗效,用副反应量表(TESS)评价药物不良反应。结果治疗6周末,研究组有效率为82.6%,显著高于对照组的67.4%(X^(2)=0.284,P=0.031);研究组2周末PANSS总分及阳性症状评分较对照组显著降低(P<0.05),其余各症状评分变化不显著(P>0.05),6周末两组之间阴性症状分存在显著性差异(P>0.05);两组不良反应无显著性差异(X^(2)=0.056,P=0.813).结论阿立哌唑联合小剂量奥氮平对首发精神分裂症患者阳性症状具有起效快的特点,对阴性症状的远期疗效更加显著,值得临床推广应用.

Objective To observe the clinical effect of aripiprazole combined with low-dose olanzapine in the treatment of first-episode schizophrenia.Methods 92 cases with first-episode schizophrenia during the period from October 2017 to April 2019 were randomly divided into 2 groups:control group and research group,46 cases in each;single administration of aripiprazole was made to cases in control group while combined administration of aripiprazole and lowdose olanzapine to those in research group;Positive and Negative Symptom Scale(PANSS)was applied in the evaluation of the curative effect at the time point of before treatment,the 2^(nd),the 4^(th),and the 6^(th)weekend after treatment while treatment emergent symptom scale(TESS)in the assessment of the adverse reactions.Results The effective rate 6 weeks after treatment in research group was 82.6%,significantly higher than that(67.4%)in control group(X^(2)=0.284,P=0.031);the total score of PANSS and the score of Negative Symptom Scale 2 weeks after treatment in research group were much lower than those in control group(P<0.05),and no obvious changes were found in the scores of other symtoms(P>0.05);there existed a significant difference in negative symptom scores between the 2 groups at the end of the 6th week after treatment(P<0.05);the adverse reactions in the 2 groups were of no differences(P>0.05).Conclusions The combined treatment with aripiprazole and low-dose olanzapine produces a fast effect on positive symptoms of the cases with first-episode schizophrenia and a greater long-term effect on negative symptoms,it is worthy of wider clinical application.