加用阿戈美拉汀治疗精神分裂症强迫症状的研究  

Clinical observation of conventional antipsychotics combined with agomelatine in schizophrenia patients with obsessive-compulsive symptoms

作　　者：肖攀攀[1] 宋来云 郑小泳 曹健伟[2] 黄淑燕 XIAO Panpan;SONG Laiyun;ZHENG Xiaeyen;CAO Jianwei;HUANG Shuyan(Department ef Psychiatry,Guangzheu Medical University Affiliated Brain Hespital,Guangzheu 510370,China.)

机构地区：[1]广州医科大学附属脑科医院精神科,广州510370 [2]江门市第三人民医院精神科 [3]广州市民政局精神病院精神科

出　　处：《中国神经精神疾病杂志》2018年第5期283-287,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的观察常规抗精神病药加用阿戈美拉汀治疗有强迫症状精神分裂症患者的疗效、安全性与经济效益。方法选择具有强迫症状的精神分裂症患者80例,按随机数字表法分为两组,在接受常规抗精神病药治疗同时,研究组加用阿戈美拉汀、对照组加用氯米帕明治疗强迫症状8周。于治疗前、出院时及出院次月随诊时分别以阳性和阴性症状量表(positive and negative symptom scale,PANSS)、Yale-Brown强迫量表(Yale-Brown obsessive-compulsion scale,Y-BCOS)评估患者症状,以社会功能缺陷筛选量表(social disability screening scale,SDSS)和肇事肇祸情况评定社会功能。出院时、出院次月随诊时以不良反应量表(treatment emergent symptom scale,TESS)比较两组安全性,药物经济学分析评价经济效益。结果治疗前两组各症状量表评分差异无统计学意义(P>0.05)。出院时、出院次月随诊时PANSS评分与治疗前的差值组间差异均无统计学意义(均P>0.05);Y-BCOS评分与治疗前的差值研究组大于对照组(均P<0.05);SDSS评分与治疗前的差值研究组大于对照组(均P<0.05)。出院次月随诊时,研究组肇事肇祸率低于对照组(P=0.004)。出院时、出院次月随诊时,研究组TESS评分均较对照组低(均P<0.05)。出院次月随诊时,研究组成本(P<0.001)、工资收入(P<0.001)高于对照组,但成本—效果比低于对照组(P<0.001)。出院次月随诊时PANSS、Y-BCOS分别与TMR、SDSS、CER呈正相关(均P<0.05),与TESS相关无统计学意义(均P>0.05);TESS与TMR、SDSS、CER呈正相关(均P<0.05)。结论常规抗精神病药加用阿戈美拉汀治疗精神分裂症的强迫症状安全有效,患者社会功能得到明显改善,并获得较好的经济和社会效益。Objective To examine the efficacy, safety, economic benefits and social function of conventional antipsychotics combined with agomelatine in the treatment of schizophrenia patients with obsessive-compulsive symptoms. Methods Eighty schizophrenic patients with obsessive-compulsive symptoms were randomly divided into two groups. The study group was treated with conventional antipsychotic drugs combined with agomelatin, and the control group combined with clomipramine for 8 weeks. Positive and negative symptom scale（PANSS） and Yale-Brown obsessive-compulsion scale（Y-BCOS） were used to evaluate the symptoms at before treatment, at discharge and one month after discharge. Social disability screening scale（ SDSS）, treatment emergent symptom scale（ TESS） and the economic benefits was used to evaluate the social function, treatment efficacy and economic status. Results Before treatment, there was no significant difference in the scores of each scale between the two groups（P〉0.05）. There was no significant difference in PANSS scores between the two groups at all time points（P〉0.05）. The difference between Y-BCOS score and pre-treatment value was higher in the study group than in the control group（P〈 0.05）. The difference between SDSS score and pre-treatment value was higher in the study group than in the control group（P〈0.05）. The TMRs were lower in the study group than in the control group at one month after discharge（P〈 0.05）. The TESS score was lower in the study group than in the control group at discharge and one month after discharge. The cost and income were higher and the cost-effect ratio was lower in the study group than in the control group at one month after discharge（P〈 0.05）. PANSS and Y-BCOS were positively correlated with TMR, SDSS and CER（P〈0.05）,but not with TESS at one month after discharge（P〉0.05）. TESS was positively correlated with TMR, SDSS and CER（ P〈 0. 05）. Conclusion The treatment of conventional antipsychotics combined with a

关 键 词：精神分裂症 强迫症状 阿戈美拉汀 

分 类 号：R749.3[医药卫生—神经病学与精神病学]