阿立哌唑治疗育龄期难治性精神分裂症的效果及对泌乳素的影响

Effect of aripiprazole on refractory schizophrenia of childbearing age and its influence on prolactin

目的探讨帕利哌酮联合阿立哌唑治疗育龄期难治性精神分裂症的效果及对泌乳素的影响。方法将80例育龄期难治性精神分裂症患者按照随机数字表法分为研究组和对照组,各40例。对照组患者给予帕利哌酮治疗,研究组患者给予帕利哌酮联合阿立哌唑治疗,两组患者均治疗8周。比较治疗前后两组患者临床症状评分、血清泌乳素水平、蒙特利尔认知评估量表评分、世界卫生组织生存质量测定量表简表评分,并比较两组患者临床疗效、不良反应发生率、治疗依从率、复发率以及再住院率。结果治疗后研究组患者阳性和阴性症状量表总分及各维度评分、血清泌乳素水平、复发率及再住院率低于对照组,治疗依从率、临床总有效率、蒙特利尔认知评估量表评分、世界卫生组织生存质量测定量表简表评分高于对照组(P<0.05或0.01)。两组患者不良反应总发生率没有明显差异(P>0.05)。结论帕利哌酮联合阿立哌唑治疗育龄期难治性精神分裂症,可显著改善病情,有效降低血清泌乳素水平,安全性高,值得推广。

Objective To explore the effect of paliperidone combined with aripiprazole on refractory schizophrenia of childbearing age and its influence on prolactin.Methods Eighty childbearing age patients with refractory schizophrenia were divided into research and control group according to random number table method,40 cases each.The control received paliperidone treatment and research group did paliperidone plus aripiprazole for 8 weeks.Before and after treatment such indexes were compared between two groups as the score on clinical symptoms,serum prolactin levels as well as scores on the Montreal Cognitive Assessment(MoCA)and World Health Organization Quality of Life Scale Brief Version(WHOQOL-BREF),so were such indexes as clinical effects,the incidences of adverse reactions after medication,treatment compliance rates,relapse rates and readmission rates.Results After treatment the total and each dimension score of the Positive and Negative Syndrome Scale(PANSS),serum prolactin levels,relapse and readmission rate were lower,and treatment compliance,clinical total effective rate and scores on the MoCA and WHOQOL-BREF higher in research than control group(P<0.05 or 0.01).There were no significant changes in the total incidences of adverse reactions in both groups after medication(P>0.05).Conclusion The combination of paliperidone and aripiprazole can significantly improve patients'conditions,effectively reduce the level of serum prolactin in the treatment of refractory schizophrenia of childbearing age,has higher safety,and is worthy of popularization.