无抽搐电休克合并奥氮平治疗难治性精神分裂症对照研究  

A comparative study of modified electroconvulsive therapy combined with Olanzapine in the treatment of treatment-- refractory schizophrenia

作　　者：周慧静[1] 茅峥嵘[1] 陈一郡[1] 宋兵福[1] 施冬青[1] 

机构地区：[1]上海市杨浦区精神卫生中心,200090

出　　处：《神经疾病与精神卫生》2009年第4期328-331,共4页Journal of Neuroscience and Mental Health

摘　　要：目的探讨无抽搐电休克治疗（MECT）合并奥氮平（悉敏）对难治性精神分裂症的疗效及安全性。方法将63例难治性精神分裂症患者随机分为研究组和对照组，分别予以MECT合并奥氮平和单用奥氮平治疗。观察期为12周。分别采用阳性和阴性症状量表（PANSS）、韦氏记忆量表（WMS）及副反应量表（TESS）评定疗效及安全性。结果（1）治疗2周末，MECT合并奥氮平组PANSS量表总分及阳性症状分较前明显下降（P〈0．05），治疗4周末，奥氮平合并MECT组PANSS量表总分及阳性症状分较单用奥氮平组明显下降（P〈0．01），治疗12周后，两组PANSS量表总分、阳性症状分、阴性症状分均较治疗前有显著性下降（P〈0．01）；（2）总有效率两组分为67．74％和62．50％，组间比较无差异（P〉0．05）；（3）奥氮平合并MECT组在MECT治疗期间WMS分明显下降（P〈0．01），但在MECT结束治疗后4～8周恢复，与单用奥氮平组相比无显著性差异（P〉0．05）；（4）两组均未见严重的不良反应。结论MECT合并奥氮平治疗难治性精神分裂症疗效肯定，安全性好，快速控制阳性症状的疗效优于单用奥氯平。Objective To investigate the efficacy and safety of modified electroconvulsive therapy （MECT） combined with olanzapine （ximin） in the treatment of treatment--refractory schizophrenia （TRS）. Methods A total of 63 inpatients with TRS were randomly assigned to MECT combined with olanzapine group and olanzapine alone group for 12 weeks treatment, and the positive and negative symp- tom scale （PANSS）, Wechsler memory seale （WMS） and the treatment emergent symptom scale （TESS） were used to evaluate the treatment effects and the side effects. Results （1）at the end of the second week, the PANSS score of total and positive symptom of olanzapine combined with MECT group was decreased significantly （P〈 0.05） ; At the end of the fourth week, it experienced a more obvious decline than that of olanzapine alone group （P 〈 0.01 ） ; After 12 weeks treatment, the PANSS score of total positive symptom and negative symptom of two groups were both significantly decreased （P 〈 0.01）. （2） total effective rates were 67.74 % and 62.50 5respectively, which showed no difference （P 〉 0.05）. （3）during the period of MECT, the WMS score of olanzapine combined with MECT group was decreased significantly （P 〈 0.01）, but recovered four to eight weeks after the endpoint of MECT, which had no difference compared with that of olanzapine alone group （P 〉 0.05）. （4）no severe side effects were found in two groups. Conclusions MECT combined with olanzapine is effective and safe in the treatment of TRS. It is superior to olanzapine alone in rapidly and dramatically improving positive symptom.

关 键 词：无抽搐电休克治疗 奥氮平 难治性精神分裂症 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.054[医药卫生—临床医学]