药物联合无抽搐电休克治疗难治性精神分裂症的疗效评估

Evaluation of the Efficacy of Sulfamethoxide and Clozapine Combined With Non Convulsive Electroconvulsive Therapy in the Treatment of Negative Symptoms of Refractory Schizophrenia

目的 评估难治性精神分裂症阴性症状患者应用氨磺必利、氯氮平与无抽搐电休克联合治疗对促进患者阴性症状及预后改善所发挥的作用。方法 选择福建省福州神经精神病防治院2022年1月—2023年1月进行治疗的难治性精神分裂症患者136例作为研究对象,随机数表法分为对照组和观察组,各68例。对照组患者联合应用氨磺必利及氯氮平治疗,观察组患者在采用氨磺必利与氯氮平治疗的基础上联合应用无抽搐电休克治疗。比较两组阴性和阳性症状量表(positive and negative symptom scale,PANSS)、韦氏记忆力量表(Webster memory strength scale,WMS-RS)、简明精神分裂症认知评估测验(brief assessment of cognitionin schizophrenia,BACS)、健康调查简表(health survey summary form,SF-36)及不良反应总发生率。结果 治疗前,两组患者PANSS各维度评分比较,差异无统计学意义(P> 0.05);治疗后,观察组患者PANSS评分均低于对照组(P<0.05)。治疗前,两组WMS-RS、BACS评分比较,差异无统计学意义(P> 0.05);治疗后,观察组患者WMS-RS、BACS评分显著高于对照组(P <0.05)。治疗前,两组生理健康与心理健康、社会关系、情感职能评分比较,差异无统计学意义(P> 0.05);治疗后,观察组患者各维度评分均高于对照组(P <0.05)。两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 难治性精神分裂症阴性症状患者采用氨磺必利、氯氮平联合无抽搐电休克能够促进病情缓解,可使患者记忆力、认知功能与生活质量获得显著改善,安全高效。

Objective To evaluate the effect of the combination therapy of amisulpiride,clozapine,and non convulsive electroconvulsive therapy on promoting negative symptoms and improving prognosis in patients with refractory schizophrenia.Methods A total of 136 patients with refractory schizophrenia who were treated at Fuzhou Neuropsychiatric Hospital from January 2022 to January 2023 were selected as the study subjects.The patients were divided into a control group and an observation group using the random number table method,with 68 cases each.The control group was treated with a combination of sulfamethoxide and clozapine,while the observation group was treated with a combination of sulfamethoxide and clozapine without convulsive electroconvulsive therapy,compare two groups of positive and negative symptom scales(PANSS),Webster memory strength scale(WMS-RS),brief assessment of cognitionin schizophrenia(BACS),Health survey summary form(SF-36),and total incidence of adverse reactions.Results Before treatment,there was no statistically significant difference in PANSS scores between the two groups of patients in all dimensions(P>0.05).After treatment,the PANSS scores of the observation group were lower than those of the control group(P<0.05).Before treatment,there was no statistically significant difference in WMS-RS and BACS scores between the two groups(P>0.05).After treatment,the WMS-RS and BACS scores of the observation group were significantly higher than those of the control group(P<0.05).Before treatment,there was no statistically significant difference in the scores of physical and mental health,social relations,and emotional function between the two groups(P>0.05).After treatment,the scores of all dimensions in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of amisulpiride and clozapine with non convulsive electroconvulsive therapy can promote remission in patients with negative symptoms of refractory schizophrenia,significantly improve memory,cognitive function,and quality of life.It is safe,efficient.