舒必利合并氟西汀治疗伴抑郁症状的精神分裂症  

The effect of the combination of sulpiride and fluoxetine in treatment of schizophrenia accompanied with depressive symptoms

作　　者：童建明[1] 杨正春[1] 

机构地区：[1]四川省自贡市精神卫生中心精神科门诊部,643020

出　　处：《神经疾病与精神卫生》2006年第6期441-444,共4页Journal of Neuroscience and Mental Health

摘　　要：目的 探讨舒必利合并氟西汀治疗精神分裂症发病期时伴有抑郁症状的临床意义。方法 72例符合CCMD--3精神分裂症诊断标准，属于首发或复发病例，具有精神运动性抑制现象，或紧张恐惧、情绪低落等抑郁体验，BPRS评分≥40分，HAMD评分≥24分，且符合舒必利为主要药物治、疗指征的门诊患者，在常规使用舒必利基础上随机分为加用氟西汀（20）mg／d和未加用氟西汀进行分组治疗。结果 两组在使用舒必利[（728．6±159．7）mg和（776．8±228．5）mg]及合并小剂量其他抗精神病药物帮助睡眠的基础上，联用组（合并氟西汀20mg／d）6周时较对照组显示了更好的显效率（95．2％和70％，经Ridit分析，u=2．15〉1．96，P〈0．05），治疗过程中没有发现恶化病例。通过BPRS和HAMD量表评分也显示不论是精神症状，还是抑郁症状都在治疗2～4周后改善更为明显（P〈0．05～0．01）。不良反应中两组基本相似，但联用组心慌不安却显著减少（P〈0．05）。结论 伴有抑郁症状的精神分裂症发病期若早期使用抗抑郁药后，不论是精神症状，还是抑郁症状都较未加用氟西汀组改善更为明显，并能更快恢复家庭或社会功能。Objective To explore the effect and prognosis of the combination of sulpiride and Fluoxetine in treating schizophrenia accompanied with depressive symptoms in restrospective study. Methods To explore the effect and prognosis of the combination of sulpiride with Fluoxetine in treating schizophrenia accompanied with depressive symptoms in restrospective study. Results Using the same dose of sulpiride（728.6 ＋ 159.7mg and 776.8 ＋ 228.5mg） and small doses of other antipsychotic drugs , combination group（ combined with Fluoxetine 20mg/d） demonstrated a better efficiency than compared group （95.2% and 70% ,Ridit show： u =2.15〉1.96, P 〈0.05） ,and there were no deterioration during the treatment. According to the scores of HAMD（hamilton depression scale） and BPRS（bridf psychiatric rating scale）, both the mental disorder or the depression symptoms had obviousily been improved in 2-4 Weeks （ P 〈 0.05-0.01 ）. The adverse reactions were probably similar to the two groups, but uneasy were significant reduced in combination Group （P 〈 0.05） . Conclusions During the treatment of schizophrenics accompanied with depressive symptoms, the combination of sulpiride and Fluoxetine is helpful to enhance the efficacy, improve the social function , reduce relapserate and increase the medicaion compliance.

关 键 词：精神分裂症 抑郁症状 舒必利 氟西汀 联用 

分 类 号：R749.3[医药卫生—神经病学与精神病学]