利培酮联合不同心境稳定剂治疗伴攻击行为精神分裂症的疗效

Efficacy of Risperidone Combined with Different Mood Stabilizers in Treatment of Schizophrenia with Aggressive Behavior

目的探讨利培酮联合不同心境稳定剂治疗伴攻击行为精神分裂症的疗效。方法回顾性分析2019年7月至2020年7月蚌埠医学院附属安民医院收治的60例精神分裂症伴攻击行为患者的临床资料,按照给药方式不同分为丙戊酸钠组(30例)和碳酸锂组(30例)。其中,丙戊酸钠组给予利培酮联合丙戊酸钠片治疗(0.4~1.2 g),碳酸锂组给予利培酮(2~6 mg)联合碳酸锂缓释片(0.6~1.5 g)治疗,共治疗4周。比较两组患者治疗前、治疗2周后、治疗4周后的阳性和阴性症状量表(PANSS)、修改版外显行为攻击量表(MOAS)评分,以及不良反应发生情况。结果PANSS评分时点间、组间的主效应差异有统计学意义(P<0.05),时点间与组间存在交互作用(P<0.01)。治疗2周和4周后,两组的PANSS评分均低于治疗前(P<0.05);且治疗4周后,碳酸锂组的PANSS评分低于丙戊酸钠组(P<0.05)。MOAS评分时点间、组间的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01)。治疗2周和4周后,两组的MOAS评分均低于治疗前(P<0.05);且治疗4周后,碳酸锂组的MOAS评分低于丙戊酸钠组(P<0.05)。碳酸锂组的总不良反应发生率为33.33%(10/30),丙戊酸钠组为36.67%(11/30),两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论利培酮分别联合碳酸锂与丙戊酸钠治疗伴攻击行为的精神分裂症疗效显著,但利培酮联合碳酸锂的疗效优于联合丙戊酸钠,安全性无显著差异。

Objective To investigate the efficacy of risperidone combined with different mood stabilizers in the treatment of schizophrenia with aggressive behavior.Methods The clinical data of 60 patients with schizophrenia with aggressive behavior treated in Anmin Hospital Affiliated to Bengbu Medical College from Jul.2019 to Jul.2020 were analyzed retrospectively.According to the dosing way they were divided into a sodium valproate group(30 cases)and a lithium carbonate group(30 cases).The sodium valproate group was treated with risperidone combined with sodium valproate tablets(0.4-1.2 g),and the lithium carbonate group was treated with risperidone(2-6 mg)combined with lithium carbonate sustained release tablets(0.6-1.5 g)for 4 weeks.The scores of positive and negative symptom scale(PANSS)and modified overt aggression scales(MOAS),and the incidence of adverse reactions were compared between the two groups before treatment,after 2 weeks of treatment and after 4 weeks of treatment.Results The main effect difference in PANSS score between time points and groups was statistically significant(P<0.05),and there was an interaction between time points and groups(P<0.01).After 2 and 4 weeks of treatment,the PANSS scores of both groups were lower than those before treatment(P<0.05);after 4 weeks of treatment,the PANSS score of the lithium carbonate group was lower than that of the sodium valproate group(P<0.05).There was significant difference in the main effect of MOAS score between time points and groups(P<0.01),and there was an interaction between time points and groups(P<0.01).After 2 and 4 weeks of treatment,the MOAS score of both groups were lower than those before treatment(P<0.05);after 4 weeks of treatment,the MOAS score of the lithium carbonate group was lower than that of the sodium valproate group(P<0.05).The total adverse reaction rate was 33.33%(10/30)in the lithium carbonate group and 36.67%(11/30)in the sodium valproate group,and there was no significant difference in the total adverse reaction rate between the two groups(P>0.05).Conclusion Risperidone combined with lithium carbonate or sodium valproate respectively has significant efficacy in the treatment of schizophrenia with aggressive behavior,while the efficacy of risperidone combined with lithium carbonate is better than that of sodium valproate,and there is no significant difference in safety.