利培酮联合小剂量氯氮平治疗精神分裂症的临床效果及安全性

Clinical effect and safety of risperidone combined with low-dose clozapine in the treatment of schizophrenia

目的 探讨利培酮联合小剂量氯氮平治疗精神分裂症的临床效果及安全性。方法 选取2017年2月至2021年1月我院接收的503例精神分裂症患者作为研究对象,采用随机数字表法将其分为对照组(252例)与研究组(251例)。对照组采用大剂量氯氮平治疗,研究组采用利培酮联合小剂量氯氮平治疗。比较两组的临床疗效、阳性和阴性症状量表(PANSS)评分、血脂、血糖水平、社会功能评分及不良反应发生情况。结果 研究组的治疗总有效率为99.60%,高于对照组的96.03%,差异具有统计学意义(P<0.05)。治疗前,两组的PANSS阳性量表、阴性量表、一般精神病理学量表评分比较,差异无统计学意义(P>0.05);治疗后,研究组的PANSS阳性量表、阴性量表、一般精神病理学量表评分均低于对照组,差异具有统计学意义(P<0.05)。治疗前、后,两组的总胆固醇、甘油三酯、血糖水平比较,差异无统计学意义(P>0.05)。治疗前,两组的社会功能各项评分无明显差异(P>0.05);治疗后,研究组的社会功能各项评分均低于对照组,差异具有统计学意义(P<0.05)。研究组的不良反应总发生率为3.59%,低于对照组的8.73%,差异具有统计学意义(P<0.05)。结论 利培酮联合小剂量氯氮平治疗精神分裂症的临床效果显著,能够有效改善患者的整体症状,促进各项社会功能提升,用药安全性高,可在临床推广应用。

Objective To investigate the clinical effect and safety of risperidone combined with low-dose clozapine in the treatment of schizophrenia. Methods A total of 503 patients with schizophrenia admitted in our hospital from February 2017 to January 2021 were selected as the study objects, and the patients were divided into control group(252 cases) and study group(251 cases) by random number table method. The control group was treated with high-dose clozapine, and the study group was treated with risperidone combined with low-dose clozapine. The clinical efficacy, Positive and Negative Syndrome Scale(PANSS) score, blood lipid level, blood glucose level, social function score and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the study group was 99.60%, which was higher than 96.03% in the control group, and the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in the scores of positive scale, negative scale and general psychopathology scale of PANSS between the two groups(P>0.05);after treatment, the scores of positive scale, negative scale and general psychopathology scale of PANSS in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). Before and after treatment, there were no significant differences in total cholesterol, triglycerides and blood glucose levels between the two groups(P>0.05). Before treatment, there were no significant differences in the scores of every item of social function between the two groups(P>0.05);after treatment, the scores of every item of social function in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total incidence of adverse reactions in the study group was 3.59%, which was lower than 8.73% in the control group, and the difference was statistically significant(P<0.05). Conclusion Risperidone combined with low-dose clozapine in the treatment of schizophrenia has significant clinical effect, it can effectively improve the overall symptoms and promote the improvement of various social functions of patients, with high drug safety, which can be popularized and applied in clinical practice.