合并心境稳定剂治疗精神分裂症的短期效果评估  

Effects of adjunctive mood stabilizer in patients with schizophrenia

作　　者：欧玉芬 周燕玲[1] 张杰[1] 曾奕彬[1] 梁莉[1] 何红波[1] 

机构地区：[1]广州市脑科医院(广州市惠爱医院,广州医科大学附属脑科医院),510370

出　　处：《四川精神卫生》2015年第4期295-298,共4页Sichuan Mental Health

基　　金：国家精神科临床重点专科建设项目子项目基金(201201-001);广州市医药卫生科技基金(20131A011083)

摘　　要：目的通过总结精神分裂症患者合并使用心境稳定剂的现状及其对短期预后的影响,了解患者的获益与风险。方法对纳入的334例精神分裂症患者进行自然观察,按是否合并使用心境稳定剂分组。采用阳性和阴性症状量表(PANSS)、自知力和治疗态度问卷(ITAQ)、副反应量表(TESS)及健康状况量表(SF-36)分别测评精神症状、自知力、药物不良反应及生活质量。结果入院时合并组PANSS总评分、兴奋因子、认知因子评分高于未合并组(P<0.05);出院时合并组PANSS阳性因子、认知因子评分仍高于未合并组(P<0.05);ITAQ、SF-36精神心理维度评分低于未合并组(P<0.05)。结论合并心境稳定剂治疗对精神分裂症患者的兴奋冲动攻击行为有效,但不影响总体症状改善,且对生活质量和自知力可能有负面影响,故使用前应谨慎评估。Objective To estimate the benefits and risks of adjunctive mood stabilizer in patients with schizophrenia through summarizing its influence on short- term prognosis. Methods The sample of 334 patients with schizophrenia from Guangzhou Brain Hospital were observed naturally,grouped by prescribing adjunctive mood stabilizers. We used Positive and Negative Syndrome Scale( PANSS),Insight and Treatment Attitudes Questionnaire( ITAQ),Treatment Emergent Symptoms Scale( TESS) and Short Form 36 Health Survey Questionnaire( SF- 36) to evaluate symptoms,pharmacologic side effects and the quality of life respectively. Results Compared to the group without being prescribed mood stabilizers,patients who combined mood stabilizers had higher scores in exciting factor and cognitive factor of PANSS five- factor model at admission( P < 0. 05),and still got higher sores in the positive factor,cognitive factor at discharge( P <0. 05),while their sores of ITAQ and SF-36 mental dimension were lower at discharge( P <0. 05). Conclusion Adjunctive mood stabilizer in patients with schizophrenia is common,and effective for treatment of excited impulse attack effectively,but it does not improve the overall symptoms,and may have a negative impact on the quality of life and insight. Therefore,clinicians should assess carefully before prescribing.

关 键 词：精神分裂症 心境稳定剂 疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]