中药方剂联合氯氮平治疗慢性精神分裂症对照研究

目的探讨中药方剂联合氯氮平治疗慢性精神分裂症的临床疗效及安全性。方法将60例慢性精神分裂症患者随机分为两组各30例,两组均给予氯氮平治疗,研究组联合中药方剂治疗,对照组联用外观与中药方剂完全相同的安慰剂治疗。观察16w。于治疗前及治疗第4w、8w、12w、16w末采用简明精神病量表、阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗16w末研究组显效率为43.3%,对照组为13.3%（χ^2=4.86,P〈0.05）。简明精神病量表及阴性症状量表评分,研究组治疗8w末起,对照组治疗12w末起较治疗前有显著性下降（P均〈0.01）,且随治疗时间的延续均呈持续性下降;简明精神病量表评分研究组总分及焦虑抑郁、缺乏活动、思维障碍、自知力因子分均较对照组下降显著（P〈0.05或0.01）;阴性症状量表评分研究组总分及各因子分均较对照组下降显著（P〈0.05或0.01）。研究组不良反应发生率显著低于对照组。结论中药方剂联合氯氮平等抗精神病药物是一种安全、有效的治疗慢性精神分裂症的方法。

A control study of Chinese medicinal formulae in Combination with clozapine in chronic schizophrenia

Objective To explore the clinical effects and safety of Chinese medicine formulae in combination with clozapine in chronic schizophrenia.Methods 60 chronic schizophrenics were randomly divided into research group(n=30)receiving clozapine plus a Chinese medicine formulae and control group(n=30)plus placebo which was identical to the Chinese medicine formulae in appearance for 16 weeks.Clinical efficacies were assessed with the Brief Psychiatric Rating Sacle(BPRS)and the Scale for Assessment of Negative Symptom(SAPS)and adverse reactions with the Treatment Emergent Symptom Scale(TESS)before treatment and at the ends of the 4th,8th,12th and 16th week.Results At the end of the 16th week,excellence rates were 43.3% in the research group and 13.3% in the control respectively(P<0.05).The scores of the BPRS and the SAPS lowered more significantly since the end of the 8th week in the research and since the end of the 12th week in the control group compared with pre-treatment(both P<0.01)and did continously along with time of therapy lasting;the BPRS total,anxiety-depression,absence of activity,thought disturbance and insight score(P<0.05 or 0.01)and the SAPS total and all factor score lowered more signifivantly in the research than in the control group(P<0.05 or 0.01).The incidences of adverse reactions were significantly lower in the research than in the control group.Conclusion Chinese medicine formulae plus clozaping is safe and effective in the treatment of chronic schizophrenia.