氯氮平联合丙戊酸镁缓释片治疗难治性精神分裂症对患者认知功能的影响

目的：研究在氯氮平口腔崩解片的基础上加用丙戊酸镁缓释片对难治性精神分裂症患者认知功能的改善作用。方法选取2014年6月至2015年6月我院精神科收治的60例难治性精神分裂症患者作为研究对象，按照随机数字表分为观察组和对照组各30例，观察组予氯氮平口腔崩解片+丙戊酸镁缓释片，对照组予氯氮平口腔崩解片+安慰剂，治疗12周。两组患者治疗前后运用阳性与阴性症状量表(PANSS)、改良版维斯康辛卡片分类测验(M-WCST)、副反应量表(TESS)分别测定临床疗效与认知功能及不良反应，并进行比较分析。结果观察组患者治疗1个月、2个月和3个月时的治疗有效率分别为73.33%(22/30)、86.67%(26/30)、96.67%(29/30)，明显高于对照组同期的46.67%(14/30)、66.33%(19/30)、70.00%(21/30)，差异均有统计学意义(P<0.05)；观察组治疗结束后（M-WCST持续错误数，错误数，非持续错误数）各因子积分分别为(10.06±2.17)分、(29.14±6.67)分、(3.07±2.98)分，均较治疗前的(18.24±4.67)分、(33.78±8.16)分、(6.42±3.34)分明显下降（P<0.05），对照组治疗结束后(M-WCST持续错误数，错误数，非持续错误数）各因子积分分别为(13.34±4.56)分、(13.17±6.56)分、(4.95±1.46)分，与治疗前的(12.57±6.66)分、（14.65±8.18）分、(5.03±1.06)分比较差异均无统计学意义(P>0.05)。治疗后观察组患者的各因子分与对照组治疗后的各因子积分比较差异均有统计学意义(P<0.05)，两组患者的不良反应总发生率相当，差异无统计学意义（P>0.05）。结论丙戊酸镁缓释片配合氯氮平口腔崩解片对难治性精神分裂症患者的认知功能有显著改善，能够更好的提高患者的社会功能，促进其回归社会。

Effect of clozapine combined with magnesium valproate sustained release tablets on cognitive function in patients with schizophrenia

Objective To study the improvement of clozapine combined with magnesium valproate sustained release tablets for cognitive function in patients with schizophrenia. Methods A total of 60 patients with intractable mental division, who admitted to the Department of Psychiatry of our hospital from June 2014 to June 2015, were select-ed as the subjects and divided into the observation group and the control group according to the random number table, with 30 cases in each group. The observation group received clozapine orally disintegrating tablets combined with mag-nesium valproate sustained release tablets, and the control group was treated with clozapine orally disintegrating tablets combined with placebo. The course of treatment was 12 weeks in the two groups. Modified version of Wisconsin Card Sorting Test (M-WCST), Positive and Negative Symptoms Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) were used to evaluate and analyze the cognitive function, clinical efficacy and adverse reactions of patients before and after treatment. Results The treatment efficiency in the observation group treated for 1 month, 2 months and 3 months were respectively 73.33% (22/30), 86.67% (26/30) and 96.67% (29/30), which were significantly higher than those in the control group during the same period [46.67% (14/30), 66.33% (19/30), 70.00% (21/30), respectively], P<0.05;Compared with before treatment [(18.24±4.67) points, (33.78±8.16) points, (6.42±3.34) points], the scores of M-WC-ST persistent error number, wrong number, non-continuous wrong number after treatment in the observation group [(10.06 ± 2.17) points, (29.14 ± 6.67) points, (3.07 ± 2.98) points] significantly decreased (P<0.05); In the control group, there was no significant difference between before [(12.57±6.66) points, (14.65±8.18) points, (5.03±1.06) points] and after treatment [(13.34±4.56) points, (13.17±6.56) points, (4.95±1.46) points] in M-WCST persistent error number, wrong num-ber, non-continuous wrong number (P>0.05). After treatment, there were significant differences between the observation group and the control group in the scores of each factor (P<0.05), but there was no significant difference between the two groups in the total adverse reaction rate (P>0.05). Conclusion Magnesium valproate sustained release tablets com-bined with clozapine orally disintegrating tablets can significantly improve the cognitive functions of patients with refrac-tory schizophrenia, which is able to improve the social function of patients and promote their social reintegration.