艾司西酞普兰联合奥氮平、改良电抽搐治疗对首发精神分裂症的疗效观察  

Observation on Efficacy of Escitalopram Oxalate Combined with Olanzapine and Modified Electroconvulsive Therapy on First-episode Schizophrenia

作　　者：纪晓斌 林闻栋 林建轩 陈海虹[1] Ji Xiaobin;Lin Wendong;Lin Jianxuan;Chen Haihong(Department of Psychiatry,Shantou Fourth People’s Hospital,Shantou 515000,Guangdong,China)

机构地区：[1]汕头市第四人民医院精神科,广东汕头515000

出　　处：《药物流行病学杂志》2021年第8期512-515,555,共5页Chinese Journal of Pharmacoepidemiology

基　　金：汕头市科技计划医疗卫生类别项目(编号:180611224014561)。

摘　　要：目的:观察艾司西酞普兰联合奥氮平、改良电抽搐治疗(MECT)对首发精神分裂症的疗效及安全性。方法:85例首发精神分裂症患者随机分为两组,对照组42例予奥氮平片联合MECT治疗,研究组43例在对照组基础上加用草酸艾司西酞普兰片。两组均治疗8周。比较治疗前后两组患者阳性与阴性症状量表(PANSS)和神经心理状态评价量表(RBANS)的评分变化,以及血清白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平变化;观察两组临床疗效,采用副反应量表(TESS)评价两组安全性。结果:治疗后,两组PANSS得分均较前明显降低,血清IL-6与IL-17水平均较前明显降低(P<0.05);且研究组上述指标均明显优于对照组(P<0.05)。治疗后研究组RBANS得分较前明显增加,且显著高于对照组(P<0.05);TESS平均得分也低于对照组(P<0.05)。研究组总有效率为90.70%,显著高于对照组的71.43%(P<0.05)。结论:艾司西酞普兰联合奥氮平、MECT治疗首发精神分裂症疗效显著,能改善患者的阳性症状、阴性症状和精神病理,调节血清IL-6与IL-17水平,提高认知功能,且安全性较高。Objective:To observe the efficacy and safety of escitalopram combined with olanzapine and modified electroconvulsive therapy(MECT)on first-episode schizophrenia.Methods:Eighty-five patients with first-onset schizophrenia were randomly divided into two groups,the 42 patients in the control group were treated with olanzapine tablets combined with MECT,and the 43 patients in the study group were treated with escitalopram oxalate tablets on the basis of the control group.Both groups were treated for 8 weeks.The changes in the scores of the Positive and Negative Symptom Scale(PANSS)and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),and changes in serum interleukin-6(IL-6)and interleukin-17(IL-17)levels were compared between the two groups before and after treatment,the clinical efficacy of the two groups was observed,and the safety of the two groups was evaluated by the Treatment Emergent Symptom Scale(TESS).Results:After treatment,the PANSS scores of the two groups were significantly lower than before treatment,the levels of serum IL-6 and IL-17 were significantly lower than before treatment(P<0.05);and the above indicators in the study group were significantly better than those in the control group(P<0.05).After treatment,the RBANS score of the study group was significantly increased,and it was significantly higher than that of the control group(P<0.05);the average score of TESS in the study group was also lower than that of the control group(P<0.05).The total effective rate in the study group was 90.70%,which was significantly higher than 71.43%in the control group(P<0.05).Conclusion:Escitalopram combined with olanzapine and MECT has a significant effect in the treatment of first-episode schizophrenia,it can improve the positive symptoms,negative symptoms and psychopathology of patients,regulate serum IL-6 and IL-17 levels,improve cognitive function,and the safety is relatively high.

关 键 词：草酸艾司西酞普兰 奥氮平 改良电抽搐治疗 首发精神分裂症 阴性症状 治疗效果 安全性 

分 类 号：R971.4[医药卫生—药品]