氯氮平联合阿立哌唑片治疗精神分裂症患者的效果及其对认知功能的影响

Effect of Clozapine Combined with Aripiprazole Tablet in the Treatment of Schizophrenia and Its Influence on Cognitive Function

目的:探讨氯氮平与阿立哌唑片联合在治疗精神分裂症中的效果及其对认知功能的影响。方法:选取2017年3月-2020年3月本院收治的60例精神分裂症患者作为研究对象,按照患者治疗先后顺序及意愿,将患者分为单纯组与联合组,每组30例。单纯组患者采用阿立哌唑片口服治疗,联合组则采用氯氮平与阿立哌唑片共同口服治疗,治疗时间为16周。对比两组治疗效果,观察两组治疗前后认知功能评分及阳性与阴性症状量表(PANSS)评分变化,治疗后4个月电话随访两组不良反应情况。结果:联合组与单纯组的总有效率分别为93.33%(28/30)、66.67%(20/30),差异有统计学意义(P<0.05);治疗前两组重复性成套神经心理状态测试量表(RBANS)及PANSS评分比较差异均无统计学意义(P>0.05),治疗后阳性、阴性症状及一般精神病理评分均降低,联合组低于单纯组(P<0.05),RBANS评分提高,联合组即刻记忆、延迟记忆、注意力、语言评分均高于单纯组(P<0.05);两组肌肉震颤、静坐不能、恶心呕吐、睡眠障碍不良反应发生情况比较差异无统计学意义(P>0.05)。结论:氯氮平与阿立哌唑片共同用于精神分裂症疾病中,与单纯一种药物相比,有效改善患者的精神状态及认知功能,联合用药后不良反应并未增加,用药安全性较高,是临床上值得应用的联合治疗方式。

Objective:To investigate the effect of Clozapine combined with Aripiprazole Tablet in the treatment of schizophrenia and its effect on cognitive function.Method:A total of 60 cases with schizophrenia admitted to our hospital from March 2017 to March 2020 were selected as the resarch subjects.According to the order of treatment and their willingness,the patients were divided into simple group and combined group,with 30 cases in each group.Patients in the simple group were treated with Aripiprazole Tablets orally,while patients in the combined group were treated with Clozapine and Aripiprazole Tables orally,for a period of 16 weeks.The therapeutic effect of the two groups was compared,the changes of cognitive function score and positive and negative symptom scale scores (PANSS) before and after treatment in the two groups were observed.The adverse reactions of the two groups were followed up by telephone 4 months after treatment.Result:The total effective rate of the combined group and the simple group were 93.33% (28/30) and 66.67% (20/30) respectively,and the difference was statistically significant (P<0.05);before treatment,there were no differences in repeatable battery for the assessment of neuropsychological status (RBANS) and PANSS scores between the two groups (P>0.05),after treatment,the positive and negative symptoms score and the general psychopathological scores were decreased,and the combined group were lower than the simple group (P<0.05),while the RBANS scores was increased,and the scores of immediate memory,delayed memory,attention and language in the combined group were higher than those in the simple group (P<0.05);there was no significant difference in the occurrence of adverse reactions of muscle tremor,akathisia,nausea and vomiting,and sleep disturbance between the two groups (P>0.05).Conclusion:When Clozapine and Aripiprazole Tablet are used together in schizophrenia,compared with a single drug,the mental state and cognitive function of patients are effectively improved,there is no increase in adverse reactions after the combination of drug use,and the drug safety is high.Therefore,the combination therapy is worthy of application in clinical.