阿立哌唑联合丙戊酸钠对难治性分裂症增效作用的临床观察  

Synergistic Effects of Aripiprazole Combined with Sodium Valproate on Refractory Schizophrenia

作　　者：陈哲[1] 王飞[1] 

机构地区：[1]天津市公安局安康医院精神病科,天津300240

出　　处：《实用临床医学（江西）》2012年第8期25-27,40,共4页Practical Clinical Medicine

摘　　要：目的探讨阿立哌唑联合丙戊酸钠治疗难治性精神分裂症患者的疗效。方法将52例难治性精神分裂症患者按随机数字表法分为2组,每组26例。联合用药组服用阿立哌唑起始剂量为5～10 mg.d-1,2周内增至15～20mg.d-1,最大剂量为20 mg.d-1;丙戊酸钠起始剂量为600 mg.d-1,最大剂量1 200 mg.d-1。单用药组服用阿立哌唑,用法同联合用药组。2组均8周为1个疗程。对2组采用阳性与阴性症状量表(PANSS)及不良反应量表(TESS)评定疗效和不良反应。结果联合用药组总有效率为80.7%,单用药组总有效率为61.5%,2组比较差异有统计学意义(χ2=4.32,P<0.05)。治疗2周末2组患者PANSS总分、阳性症状分、精神病理症状分较治疗前均有显著下降(均P<0.05),且随着治疗时间的延续均呈持续性下降趋势。单用药组阴性症状分虽较治疗前有所下降,但差异无统计学意义(P>0.05)。治疗4周末单用药组阴性症状分较治疗前有显著下降(P<0.05)。联合用药组治疗后各时间段的阳性症状分、阴性症状分、精神病理及总分与单用药组比较均有显著下降(P<0.05或P<0.01)。结论阿立哌唑联合丙戊酸钠治疗难治性精神分裂症可提高疗效,改善阴性症状、精神病理症状且安全性高,依从性好。Objective To investigate the effects of aripiprazole combined with sodium valproate on refractory schizophrenia.Methods Fifty-two patients with refractory schizophrenia patients were randomly divided into two groups,with 26 patients in each group.The combined group was given aripiprazole from starting dose of 5-10 mg.d-1 to 15-20 mg.d-1 within 2 weeks and sodium valproate at a starting dose of 600 mg.d-1（maximum dose 1 200 mg.d-1）.Single drug group was treated with aripiprazole from starting dose of 600 mg.d-1 to 1 200 mg.d-1.The treatment course was 8 weeks.The efficacy and adverse reaction were assessed by using positive and negative symptom scale（PANSS）and adverse reaction scale（TESS）.Results The total effective rate in combined group was significantly higher than that in single drug group（80.7% vs 61.5%,χ2=4.32,P〈0.05）.The scores of PANSS,positive symptoms and psychiatric symptoms at the end of treatment for 2 weeks were significantly lower than those before treatment in both group（P〈0.05）,and the scores decreased in a time-dependent manner.In single drug group,the scores of negative symptoms did not significantly change at the end of treatment for 2 weeks compared with scores before treatment（P〉0.05）,but obviously decreased at the end of treatment for 4 weeks（P 〈0.05）.Compared single drug group,the scores of positive symptoms,negative symptoms, psychiatric pathology and PANSS significantly decreased in combined group（P 〈0.05 or P 〈0.01）.Conclusion The combined use of aripiprazole and sodium valproate can improve curative effect,negative symptoms and psychiatric symptoms with high safety and good compliance in the treatment of refractory schizophrenia.

关 键 词：丙戊酸钠 阿立哌唑 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]