小剂量氨磺必利合并奥氮平治疗首发精神分裂症患者的对照研究

A control study on the treatment of first-onset schizophrenia with low dose of ammonia combined with low dose of olanzapine

目的了解小剂量氨磺必利合并小剂量奥氮平治疗首发精神分裂症患者的疗效和安全性。方法选择2016年3月1日—2017年3月17日在本院门诊或住院治疗的首发精神分裂症患者92例作为研究对象,按治疗方式的不同分为研究组和对照组两组,每组各46例。研究组予以小剂量氨磺必利合并小剂量奥氮平治疗,对照组予以可变剂量奥氮平治疗。采用自编一般情况调查表、阳性与阴性症状量表(PANSS)、临床疗效总评量表(CGI)及副反应量表(TESS)对两组患者进行评定,同时检测其身高、体质量、血糖、胆固醇、甘油三酯等。结果治疗前两组体质量指数、血糖、胆固醇、甘油三酯、PANSS总分及各因子分差异均无显著性意义(P>0.05)。在治疗4周、8周、12周后两组PANSS总分及各因子分减分都很明显(P<0.05或P<0.01);研究组在治疗4周后PANSS总分及各因子分减分最明显,与对照组相比,差异有显著性意义(P<0.05或P<0.01);研究组在治疗8周后PANSS总分及各因子分减分仍较对照组明显(P<0.05)。但在治疗12周后两组PANSS总分及各因子分差异没有显著性意义(P>0.05)。研究组治疗总有效率为89.13%,对照组治疗总有效率为86.96%,两组临床治疗效果比较,差异无显著性意义(P>0.05)。对照组的体质量指数(BMI)、血糖、胆固醇、甘油三酯在治疗前后自身及与研究组比较均有明显升高(P<0.05或P<0.01),而研究组在这些方面变化不明显(P>0.05)。在治疗12周后研究组仅有3例患者(6.52%)体重轻微增加;对照组有6例嗜睡(13.04%)、18例体重增加(39.13%)及5例心电图异常(8.70%)。结论小剂量氨磺必利合并小剂量奥氮平治疗精神分裂症起效快、疗效好、副作用少。

Objective To study the efficacy and safety of low dose of ammonia combined with low dose of olanzapine in the treatment of first-onset schizophrenics.Methods Totally 92 cases patients with first-onset schizophrenics got treatment in the outpatient and inpatient department were enrolled as study subjects.They were divided into study group and control group according to the treatment methods,46 cases in each group.Patients in study group received low dose of ammonia combined with low dose of olanzapine,and patients in control group received olanzapine alone.The patients were assessed by of self-made general information questionnaire,positive and negative symptom scale(PANSS)and treatment emergent symptom scale(TESS).The height,body mass,blood sugar,cholesterol,and triglycerides of the two groups were tested.Results There was no significant difference body mass index(BMI),blood sugar,cholesterol,triglycerides,the total scores of PANSS and the points of each factor between the two groups before the treatment(P>0.05).After 4 weeks,8 weeks and 12 weeks of treatment,the total scores of PANSS in the two groups and the points of each factor significantly reduced(P<0.05 or P<0.01).After 4 weeks of treatment,the reduction of PANSS total score and each factor score of the study group were the most significant,and the difference was significant compared with the control group(P<0.05 or P<0.01).The reduction of total scores of PANSS and the points of each factor after 8 weeks of treatment were still higher than those of the control group(P<0.05).But there was no significant difference between the two groups in the total scores of PANSS and the factors after 12 weeks of treatment(P>0.05).The total effective rate of treatment in the study group was 89.13%,and the total effective rate of treatment in the control group was 86.96%,there was no significant difference between the two groups(P>0.05).After treatment,the BMI,blood sugar,cholesterol,triglycerides in the control group was significantly increased compared with those before and those of the study group(P<0.05 or P<0.01),and the changes of the study group were not obvious(P>0.05).After 12 weeks of treatment,only 3 patients(6.52%)had a slight increase in body weight,but there were 6 cases of drowsiness(13.04%),18 cases of weight gain(39.13%)and 5 ECG abnormalities(8.70%)in the control group.Conclusions Low dose of ammonia combined with low dose of olanzapine is effective for schizophrenia.It works better,has fewer side effects.