氯氮平联合家庭治疗对难治性精神分裂症患者的效果及对其骨密度、催乳素和家庭功能的影响

Effect of Clozapine combined with family therapy in patients with refractory schizophrenia and its impact on their bone density,prolactin,and family function

目的 探讨氯氮平联合家庭治疗对难治性精神分裂症患者的效果及对其骨密度、催乳素和家庭功能的影响。方法 选取2019年1月至2022年1月安徽省阜阳市第三人民医院精神科九病区诊治的精神分裂症患者120例作为研究对象,根据随机数字表法将其分为对照组和联合组,各60例。对照组采用氯氮平治疗,联合组采用氯氮平联合家庭治疗。比较两组治疗效果、世界卫生组织残疾评定量表第2版(WHO-DASⅡ)评分、骨密度、催乳素等指标。结果 治疗后,联合组疗效优于对照组,差异有统计学意义(P<0.05);整体分析发现:两组WHO-DASⅡ评分组间比较、时间比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组组内各时间点WHO-DASⅡ评分比较,差异有统计学意义(P<0.05);组间比较:联合组治疗3、9个月WHO-DASⅡ评分低于对照组,差异有统计学意义(P<0.05)。整体分析发现:两组骨密度、催乳素组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组组内各时间点骨密度、催乳素比较,差异有统计学意义(P<0.05);组间比较:联合组治疗3、9个月骨密度高于对照组,催乳素水平低于对照组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论 氯氮平联合家庭治疗有助于提高难治性精神分裂患者的疗效,并减少对骨密度、催乳素的影响。

Objective To explore the effect of Clozapine combined with family therapy in patients with refractory schizophrenia and its impact on their bone density,prolactin,and family function.Methods A total of 120 patients with schizophrenia diagnosed and treated in the Ward Nine,Department of Psychiatry,Fuyang Third People’s Hospital,from January 2019 to January 2022 were selected as the study subjects,and according to the random number table method they were divided into control group and combined group,with 60 cases in each group.The control group was treated with Clozapine,and the combined group was treated with Clozapine combined with family,and both groups were treated for three months.The treatment effect,World Health Organization disability assessment scheduleⅡ(WHO-DASⅡ)edition Chinese version score,bone mineral density,prolactin,and other indexes of the two groups were compared respectively.Results After treatment,the treatment effect of the combined group was better than that of the control group,and the difference was statistically significant(P<0.05);the overall analysis found that:inter-group comparison of WHO-DASⅡscores,time-point comparison,and interaction differences between the two groups were statistically significant(P<0.05).Further two-by-two comparisons,intra-group comparisons:the differences in WHO-DASⅡscores at each time point between the two groups were statistically significant(P<0.05);inter-group comparisons:the WHO-DASⅡscores of the combined group were lower than those of the control group at three and nine months of treatment,and the differences were statistically significant(P<0.05).Overall analysis revealed that the differences in bone mineral density,prolactin between groups,time point comparison and interaction between the two groups were statistically significant(P<0.05).Further two-by-two comparisons,intra-group comparisons:the differences in bone density and prolactin between the two groups at each time point were statistically significant(P<0.05);inter-group comparisons:at three and mine months of treatment,the bone density of the combined group was higher than that of the control group and the prolactin level was lower than that of the control group,and the differences were statistically significant(P<0.05).Comparison of the total incidence of complications between the two groups,the difference was not statistically significant(P<0.05).Conclusion Combined family therapy with Clozapine enhances treatment outcomes in refractory schizophrenia,mitigating effects on bone density and prolactin levels.