喹硫平联合丙戊酸钠对精神分裂症急性发作期患者的疗效和安全性评价  

Evaluation of the efficacy and safety of quetiapine combined with sodium valproate in patients with acute exacerbation of schizophrenia

作　　者：马东丽 罗加国 蒋丹 黄堂辉 陈岗 Ma Dong-li;Luo Jia-guo;Jiang Dan;Huang Tang-hui;Chen Gang(Department of Acute Psychiatry,Chengdu Jinxin Psychiatric Hospital,Chengdu 610000,China)

机构地区：[1]成都锦欣精神病医院急性精神科,成都610000

出　　处：《中国药物应用与监测》2024年第3期256-259,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的研究喹硫平联合丙戊酸钠治疗精神分裂症的临床疗效和不良反应情况。方法选取2019年8月至2023年8月于成都锦欣精神病医院就诊的124例精神分裂患者,按照随机数字表法分为观察组(n=62)和对照组(n=62)。对照组患者给予丙戊酸钠缓释片治疗,观察组在对照组基础上给予喹硫平治疗。治疗6周后,比较两组患者总有效率、一般精神病理量表、阴性症状量表(SANS)、阳性症状量表(SAPS)、阳性和阴性症状量表(PANSS)及阳性和阴性综合症状量表兴奋因子量表(PANSS-EC)得分的差异,并比较两组患者治疗前后血清泌乳素(PRL)和皮质醇(COR)水平的变化及不良反应发生率。结果治疗6周后,观察组总有效率[87.10%(54/62)]高于对照组[70.97%(44/62)](χ^(2)=4.867,P<0.05)。治疗6周后,观察组一般精神病理量表、SANS量表、SAPS量表、PANSS量表及PANSS-EC量表得分[(20.63±8.25)分、(12.06±5.16)分、(11.95±5.14)分、(41.28±4.51)分、(10.54±4.51)分]低于对照组([26.51±9.95)分、(16.08±8.05)分、(14.52±6.28)分、(50.24±4.27)分、(13.96±4.96)分](t=12.904,11.094,14.063,20.475,4.012,均P<0.05)。观察组PRL[(206.58±26.24)μg·L^(-1)]和COR[(38.16±4.81)μg·L^(-1)]水平均低于对照组[PRL(254.21±28.65)μg·L^(-1)和COR(43.93±4.21)μg·L^(-1)(t=9.653,7.108,均P<0.05)]。两组患者的不良反应发生率[6.45%(4/62),8.06%(5/62)]比较差异无统计学意义(χ^(2)=0.120,P=0.729)。结论喹硫平联合丙戊酸钠治疗能有效改善精神分裂症患者急性发作的临床症状,调节患者的内分泌功能,且安全性良好。Objective To explore the clinical efficacy and adverse effect profile of quetiapine combined with sodium valproate in the treatment of schizophrenia.Methods Using a randomized numerical table approach,124 patients with schizophrenia who were admitted to Chengdu Jinxin Psychiatric Hospital from August 2019 to August 2023 were selected and divided into two groups:an observation group(n=62)and a control group(n=62).Patients in the control group were given sodium valproate extended-release tablets,and those in the observation group were given quetiapine on the basis of the control group.After 6 weeks of treatment,the differences in total effective rate,general psychopathology scale,negative symptom scale(SANS),positive symptom scale(SAPS),positive and negative symptom scale(PANSS)and positive and negative combined symptom scale excitability factor scale(PANSS-EC)scores of the two groups were compared,and the differences of serum prolactin(PRL)and cortisol(COR)levels before and after treatment were also compared.The incidence of adverse reactions was compared between the two groups.Results After 6 weeks of treatment,compared with the total effective rate(70.97%(44/62))in the control group,the total effective rate(87.10%(54/62))in the observation group was significantly higher(χ^(2)=4.867,P<0.05).After 6 weeks of treatment,the scores of the General Psychopathology Scale,SANS Scale,SAPS Scale,PANSS Scale,and PANSS-EC Scale in the observation group((20.63±8.25),(12.06±5.16),(11.95±5.14),(41.28±4.51),and(10.54±4.51)points)were lower than the scores in the control group((26.51±9.95),(16.08±8.05),(14.52±6.28),(50.24±4.27),and(13.96±4.96)points(t=12.904,11.094,14.063,20.475,4.012,all P<0.05).The PRL((206.58±26.24)μg·L^(-1))and COR((38.16±4.81)μg·L^(-1))levels in the observation group were lower than those in the control group(PRL(254.21±28.65)μg·L^(-1),COR(43.93±4.21)μg·L^(-1))(t=9.653,7.108,both P<0.05).There was no statistically significant difference in the incidence of adverse reactions(6.45%(4/62)

关 键 词：喹硫平 丙戊酸钠 精神分裂症 疗效 兴奋激越 内分泌代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]