利培酮合并赛来昔布治疗精神分裂症首次发病患者的随机双盲对照研究  

Adjunctive celecoxib treatment with risperidone in first-episode schizophrenia： a double blind, randomized and placebo controlled trial

作　　者：陈大春[1] 张向阳[2] 李艳丽[1] 王宁[1] 杨可冰[1] 聂鹰[1] 谭云龙[2] 周东丰[3] 

机构地区：[1]北京回龙观医院二科,100096 [2]北京回龙观医院生物精神医学研究室,100096 [3]北京大学精神卫生研究所

出　　处：《中华精神科杂志》2008年第3期160-164,共5页Chinese Journal of Psychiatry

基　　金：美国斯坦利基金资助项目（03T-459,5T-726）

摘　　要：目的评估利培酮合并赛来昔布对精神分裂症首次发病（以下简称首发）患者的临床疗效及安全性。方法符合美国精神障碍诊断与统计手册第4版诊断标准的精神分裂症首发住院患者90例，随机分到利培酮＋赛来昔布组（研究组，46例）或利培酮＋空白剂组（对照组，44例），观察时间均为12周。以阳性和阴性症状量表（PANSS）、临床疗效总评量表（CGI）、汉密尔顿抑郁量表（HAMD）评定临床疗效，以治疗中需处理的不良反应量表（TESS）、Simpson锥体外系副反应量表（SEPS）、异常不自主运动评定量表（AIMS）评定药物不良反应和锥体外系副反应。结果两组患者治疗前后比较，PANSS总分及各分量表分均明显下降（P均〈0．05）；研究组PANSS总分、分量表分、HAMD评分较对照组的降低更为明显，差异均有统计学意义（P均〈0．05）。研究组总有效率（66％）明显高于对照组（26％）；χ^2=16．1，P=0．001。治疗第12周末，两组TESS、SEPS、AIMS评分的差异均无统计学意义（P均〉0．05）；研究组患者体质量的增加（4±5）kg，明显高于对照组（1±4）kg，t=2．6，P〈0．05。结论赛来昔布可以提高利培酮对首发精神分裂症的疗效。Objective To evaluate the clinical efficacy, side-effects of celecoxib added on risperidone for the first-episode patients with schizophrenia. Methods Ninety inpatients with first-episode schizophrenia were enrolled and assigned randomly into risperidone plus celecoxib group （46 cases ） and risperidone plus placebo group （44 cases）. The dosage of risperidone with initial 2 mg/d was adjusted according to the clinical efficacy and side-effects, and the dosage of celecoxib was 200 mg/d for the first week, and maintained at 400 mg/d until the end of 12-week treatment. The clinical efficacy was rated with the Positive and Negative Syndrome Scale （PANSS）, and the Clinical Global Impression Scale. The depressive symptoms were measured with the Hamilton Depression Scale （HAMD）. The safety and tolerability was assessed with the Treatment Emergent Symtom Scale, Simpson-Angus Scale for extrapyramidal side-effects and Abnormal Involuntary Movement Scale. Results The total score and the subscale scores of PANSS were markedly lower at post-treatment than pre-treatment in both groups （ all P 〈 0. 05 ）. The celecoxib group had a lower PANSS total score, general psychopathology subscore, negative symptom subscore, and HAMD score （ all P 〈 0. 05 ） compared with the placebo group. Conclusion Celecoxib may promote the efficacy of antipsychotic drugs in treating first-episode schizophrenia.

关 键 词：精神分裂症 环氧化酶2抑制剂 利哌立酮 赛来昔布 

分 类 号：R686[医药卫生—骨科学]