摘要
目的:探讨根据利培酮早期治疗反应调整治疗方案对精神分裂症患者疗效及安全性影响。方法:120例精神分裂症患者随机分为两组,两组均给予利培酮单药治疗并于2周内滴定至4~6 mg/d;对照组以此剂量维持治疗;研究组治疗第2周末阳性与阴性症状量表(PANSS)减分率<20%的患者替换为奥氮平治疗(10~20 mg/d),减分率≥20%的患者继续利培酮治疗;疗程共8周。治疗前、治疗第2、4、8周末分别进行PANSS和治疗中出现的症状量表(TESS)评分。结果:研究组49例、对照组47例完成8周观察;治疗第4、8周末研究组PANSS总分、阳性症状分及治疗第8周末一般精神病理分显著低于对照组(P<0.05或P<0.01);阴性症状分各时间点两组间差异无统计学意义;治疗后各时间点TESS评分研究组明显低于对照组(P均<0.01)。结论:根据利培酮早期治疗反应调整治疗方案能明显改善精神分裂症患者的症状,减轻不良反应。
Objective:To investigate the early effect of adjusting treatment according to early response of risperidone on efficacy and safety in patients with schizophrenia.Method:A total of 120 patients with schizophrenia were randomly divided into study group and control group.Both groups were treated with risperidone and titrated to 4-6 mg/d within 2 weeks.The control group maintained the treatment at this dose.For the study group,at the end of the second week of treatment,the cases with the rate of score reduction of positive and negative symptoms scale(PANSS)over 20%were continue treated with risperidone continuely;and the others with the rate of PANSS score reduction less than 20%were treated with olanzapine in replacement(10-20 mg/d).The treatment was 8 weeks.Before treatment and 2,4,and 8 weeks after treatment,the patients were assessed by PANSS and treatment emergent symptom scale(TESS).Results:Total 49 cases in the study group and 47 cases in the control group completed the 8 weeks observation.The total score of PANSS and positive symptom score after 4 and 8 weeks,and the general psychiatric score after 8 weeks of the treatment in the study group were significantly lower than those in the control group(all P<0.05).However,the score of negative symptom showed no significant difference between the two groups.After treatment,The TESS score at each time point in the study group were significantly lower than those in the control group(all P<0.01).Conclusion:Adjusting the treatment plan according to the early treatment response of risperidone can obviously improve the symptoms of schizophrenia and reduce the adverse reactions.
作者
张素允
郗玲燕
朱凤英
陈英光
乔静爽
高兴
许艳艳
ZHANG Su-yun;XI Ling-yan;ZHU Feng-ying;CHEN Ying-guang;QIAO Jing-shuang;GAO Xing;XU Yan-yan(Hengshui Mental Hospital,Hengshui 053800,China)
出处
《临床精神医学杂志》
2019年第5期317-319,共3页
Journal of Clinical Psychiatry
基金
河北省医学科学研究重点课题计划(20181566)
关键词
精神分裂症
治疗反应评估
利培酮
schizophrenia
treatment response assessment
risperidone
