摘要
目的 探讨丙戊酸钠联合奥氮平治疗男性难治性精神分裂症(TRS)效果及对认知功能、催乳素(PRL)、生长激素(GH)、同型半胱氨酸(Hcy)的影响。方法 选取2019年6月—2021年12月收治的男性TRS 96例,根据治疗方法不同将其分为观察组(49例)和对照组(47例)。观察组采用丙戊酸钠联合奥氮平治疗,对照组采用奥氮平治疗。比较2组临床疗效、认知功能和血清PRL、GH、Hcy水平,以及不良反应。结果 治疗12周后,观察组总有效率高于对照组;阳性和阴性症状量表阳性症状分、阴性症状分、一般精神病理症状分、总分和认知功能成套测验系统连线测试、工作记忆、操作速度2组均低于或短于治疗前,且观察组低于或短于对照组(P<0.05)。治疗12周后,2组血清PRL高于治疗前,血清Hcy低于治疗前,且观察组血清Hcy高于对照组(P<0.05)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 丙戊酸钠联合奥氮平较单用奥氮平治疗男性TRS效果显著,有利于临床症状改善,提高认知功能,且对血清PRL、GH影响及安全性相当,但需重视丙戊酸钠对血清Hcy的影响。
Objective To investigate the efficacy of Sodium Valproate combined with Olanzapine in the treatment of treatment-resistant schizophrenia(TRS)in male patients and its impact on cognitive function,serum prolactin(PRL),growth hormone(GH)and homocysteine(Hcy).Methods A total of 96 male patients with TRS admitted to the hospital from June 2019 to December 2021 were selected,and divided into control group(n=47)and observation group(n=49)by random number table method.Patients in the observation group were treated with Sodium Valproate combined with Olanzapine,and those in the control group were treated with Olanzapine.Clinical effect,cognitive function,and serum PRL,GH and Hcy levels as well as adverse reactions during treatment were compared between the two groups.Results At 12 weeks after treatment,the effective rate of treatment in the observation group was higher than that in the control group.The positive symptom score,negative symptom score,general psychopathological symptom score,total score and connection test of cognitive function test system,working memory,and operation speed of the Positive and Negative Symptom Scale were all lower or shorter than those before treatment in both groups,which were lower or shorter in the observation group than in the control group(P<0.05).At 12 weeks after treatment,serum PRL in both groups was higher than that before treatment,serum Hcy was lower than that before treatment,and serum Hcy in observation group was higher than that in control group(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with Olanzapine alone,Sodium Valproate combined with Olanzapine is more effective in the treatment of male patients with TRS.The latter is beneficial to the improvement of clinical symptoms and cognitive function.The impact on serum PRL and GH,and safety of the two treatment methods are similar.Attention should be paid to the impact of Sodium Valproate on serum Hcy.
作者
赵哲婷
徐方
陈磊
胡承国
马莉莉
ZHAO Zhe-ting;XU Fang;CHEN Lei;HU Cheng-guo;MA Li-li(The Second Department of Psychiatry,the Second People's Hospital of Lu'an City,Lu'an,Anhui 237000,China;Department of Psychiatry,the Fourth People's Hospital of Hefei City,Hefei 230022,China)
出处
《临床误诊误治》
CAS
2022年第8期44-47,共4页
Clinical Misdiagnosis & Mistherapy
基金
安徽省教育厅自然科学重点项目(KJ2019A915)。
关键词
精神分裂症
男性
丙戊酸钠
奥氮平
认知功能
催乳素
生长激素
同型半胱氨酸
Schizophrenia
Male
Sodium valproate sustained
Olanzapine
Cognitive function
Prolactin
Growth hormone
Homocysteine
