奥氮平合并艾司西酞普兰治疗精神分裂症阴性症状

目的探讨奥氮平合并艾司西酞普兰治疗精神分裂症阴性症状的疗效和安全性。方法将75例以阴性症状为主的精神分裂症患者随机分为奥氮平合并艾司西酞普兰治疗组(研究组,38例)和奥氮平治疗组(对照组,37例),疗程12周。于治疗前和治疗第2、4、8、12周末使用阳性和阴性症状量表(PANSS)、阴性症状量表(SANS)、临床疗效总评量表病情严重程度(CGI-SI)评定疗效,治疗中出现的症状量表(TESS)评定不良反应。结果 12周末,研究组和对照组有效率分别为78.95%和62.16%,差异有统计学意义(χ2=12.103,P0.01)。2周末研究组PANSS总分及各因子分显著下降(P0.05或P0.01),而对照组4周末阴性症状因子分较基线下降(t=2.418,P0.05);组间比较,8周末和12周末研究组阴性症状因子分低于对照组(t=2.595,2.796;P0.05)。4周末,两组SANS总分较基线下降(t=8.574,4.438;P0.01),研究组情感平淡因子分明显下降(t=5.415,P0.01);8周末,研究组SANS总分、情感平淡分、注意障碍分明显低于对照组(t=4.120,3.429,2.165;P0.05);12周末,研究组意志缺乏和兴趣缺乏分明显低于对照组(t=3.402,4.014;P0.01)。8周末和12周末研究组CGI-SI评分低于对照组(t=2.729,3.284;P0.01)。两组不良反应轻微。结论奥氮平合并艾司西酞普兰改善精神分裂症阴性症状比单用奥氮平起效快、疗效好,安全性高。

Olanzapine Combined with Escitalopram for Negative Symptoms of Schizophrenic

Objective To explore the efficacy and safety of olanzapinein combined with escitalopram in the treatment of negative symptoms of schizophrenic .Methods 75 schizophrenic patients with predominant negative symptoms were randomly divided into study group（n=38）treated with olanzapine combined with escitalopram and control group （n=37）treated with olanzapine for 12 weeks.Posi-tive and Negative Syndrome（PANSS）,Negative Symptoms（SANS）,Clinical Global Impression Severity of Illness （CGI-SI）,Treatment Emergent Symptoms Scale（TESS）were used to evaluate the efficacy and the side effect at the baseline and at the end of the 2,4,8,12 week after treatment.Results The clinical effective rates in study group and control group were 78.95%and 62.16%respectively（χ2=12.103,P〈0.01）.After 2 weeks,the total scores and factors scores of PANSS showed significantly difference （ P〈0.01） in study group（P〈0.05 or P〈0.01 ）.However,the scores of the negative symptoms in control group decreased significantly after 4 weeks（t=2.418,P〈0.05）.The negative symptom scores in the study group were significantly lower than those the control group at the 8th and 12th week（t=2.595,2.796;P〈0.05）.The total scores of SANS in both groups decreased significantly after 4 weeks（t=8.574, 4.438;all P〈0.01.）The factor score of apathy of SANS in study group decreased after 4 weeks（t=5.415,P〈0.01）.After 8 weeks, the total scores and scores of emotional dull ,attention dysfunction of SANS in study group were significantly lower than those in control group （t=4.120,3.429,2.165;P〈0.05）. After 12 weeks,the scores of volition abulia and interest -social lack in study group were significantly lower （t=3.402,4.014,all P〈0.01）.The scores of CGI-SI in study group were significantly lower than those in control group at the 8th and 12th week（t=2.729,3.284;all P〈0.01）.Adverse effects were low in both groups.Conclusion Olanzapine com-bined with escitalopram has rapid response ,good efficacy and safety in the treatment of negative symptoms of schizophrenic .