丁螺环酮联合哌罗匹隆治疗精神分裂症疗效观察

Clinical effect of buspirone combined with piperopirone in the treatment of schizophrenia

目的探讨丁螺环酮联合哌罗匹隆治疗精神分裂症的临床疗效。方法选择郑州市第八人民医院2017年11月至2020年11月收治的92例巩固期精神分裂症患者为研究对象,采用掷硬币法将患者分为观察组(n=46)和对照组(n=46)。所有患者入院后给予心理治疗,在此基础上,对照组患者口服盐酸哌罗匹隆片,观察组患者口服盐酸哌罗匹隆片和盐酸丁螺环酮片,2组患者均治疗3个月。分别于治疗前、治疗3个月时采用阳性与阴性症状量表(PANSS)评估2组患者的症状严重程度,采用蒙特利尔认知评估量表(MoCA)评估2组患者的认知功能,采用焦虑自评量表(SAS)评估2组患者的焦虑程度。分别于治疗前、治疗3个月时采用化学发光法检测2组患者血清脑源性神经营养因子(BDNF)、胶质源性神经营养因子(GDNF)、5-羟色胺(5-HT)水平。采用治疗伴发症状量表(TESS)评估患者不良反应程度,比较2组患者治疗期间不良反应发生率。结果治疗前2组患者的阴性症状、阳性症状、一般精神病理症状评分比较差异均无统计学意义(P>0.05)。治疗3个月时,2组患者的阴性症状、阳性症状、一般精神病理症状评分均显著低于治疗前(P<0.05);且观察组患者的阴性症状、阳性症状、一般精神病理症状评分显著低于对照组(P<0.05)。治疗前2组患者的MoCA、SAS评分比较差异均无统计学意义(P>0.05)。治疗3个月时,2组患者的MoCA评分显著高于治疗前,SAS评分显著低于治疗前(P<0.05);且观察组患者的MoCA评分显著高于对照组,SAS评分显著低于对照组(P<0.05)。治疗前2组患者血清中BDNF、GDNF、5-HT水平比较差异无统计学意义(P>0.05)。治疗3个月时,2组患者血清中BDNF、GDNF、5-HT水平均显著高于治疗前(P<0.05);且观察组患者血清中BDNF、GDNF、5-HT水平显著高于对照组(P<0.05)。对照组和观察组患者不良反应发生率分别为8.70%(4/46)、13.04%(6/46),2组患者不良反应发生率比较差异无统计学意义(χ^(2)=0.112,P>0.05)。对照组和观察组患者的TESS评分分别为2.58±0.12、2.62±0.16,2组患者的TESS评分比较差异无统计学意义(P>0.05)。结论丁螺环酮联合哌罗匹隆治疗精神分裂症可进一步减轻患者的临床症状和焦虑程度,改善认知功能,还可改善患者血清中神经递质水平,且不会增加不良反应。

Objective To explore the clinical efficacy of buspirone combined with piperopirone in the treatment of schizophrenia.Methods A total of 92 schizophrenia patients who were in consolidation phase admitted to the Eighth People′s Hospital of Zhengzhou from November 2017 to November 2020 were selected as the study subjects.The patients were divided into observation group(n=46)and control group(n=46)by coin toss method.All patients were given psychotherapy.Based on this,the patients in the control group took piperopirone hydrochloride tablets orally;and the patients in the observation group took piperopirone hydrochloride tablets and buspirone hydrochloride tablets orally.The patients in both groups were treated for 3 months.The symptom degree of patients in the two groups was evaluated by positive and negative symptoms scale(PANSS),the cognitive function of patients in the two groups was evaluated by Montreal cognitive assessment scale(MoCA)and the anxiety level of patients in the two groups was evaluated by self-evaluation of anxiety scale(SAS)before treatment and after three months of treatment.The serum levels of brain-derived neurotrophic factor(BDNF),glial-derived neurotrophic factor(GDNF)and 5-hydroxytryptamine(5-HT)were measured by chemiluminescence method before treatment and after three months of treatment.The incidence of adverse reactions and the scores of treatment emergent symptom scale(TESS)of patients were compared between the two groups.Results There was no significant difference in the scores of negative symptoms,positive symptoms and general psychopathological symptoms between the two groups before treatment(P>0.05).The scores of negative symptoms,positive symptoms and general psychopathological symptoms of patients in the two groups after three months of treatment were significantly lower than those before treatment(P<0.05).The scores of negative symptoms,positive symptoms and general psychopathological symptoms of patients in the observation group were significantly lower than those in the control group after three months of treatment(P<0.05).There was no significant difference in MoCA and SAS scores of patients between the two groups before treatment(P>0.05).The MoCA score of patients in the two groups after three months of treatment was significantly higher than that before treatment,and the SAS score was significantly lower than that before treatment(P<0.05).The MoCA score of patients in the observation group was significantly higher than that in the control group,and the SAS score was significantly lower than that in the control group after three months of treatment(P<0.05).There was no significant difference in the serum levels of BDNF,GDNF and 5-HT of patients between the two groups before treatment(P>0.05).The serum levels of BDNF,GDNF and 5-HT of patients in the two groups after three months of treatment were significantly higher than those before treatment(P<0.05).The serum levels of BDNF,GDNF and 5-HT of patients in the observation group were significantly higher than those in the control group after three months of treatment(P<0.05).The incidence of adverse reactions of patients in the control group and the observation group was 8.70%(4/46)and 13.04%(6/46),respectively;there was no significant difference in the incidence of adverse reactions of patients between the two groups(χ^(2)=0.112,P>0.05).The TESS scores of patients in the control group and the observation group were 2.58±0.12 and 2.62±0.16,respectively;there was no significant difference in the TESS scores of patients between the two groups(P>0.05).Conclusion The combination of buspirone with piperopirone in patients with schizophrenia further reduces clinical symptoms and anxiety,improves cognitive function and neurotransmitter levels without increasing adverse reactions.