阿立哌唑联用米氮平治疗难治性精神分裂症临床研究

目的 探讨阿立哌唑联用米氮平治疗难治性精神分裂症的临床疗效及安全性,为临床更合理的用药提供依据.方法 将120例难治性精神分裂症患者随机分为阿立哌唑联用米氮平组（联用组）和氯氮平组（单用组）,每组60例,治疗时间为12周.用阳性和阴性症状量表（PANSS）、临床疗效大体评定量表（CGI）评价疗效,用药物不良反应评定量表（TESS）评估不良反应发生率.结果 联用组有效率为58.3％,单用组有效率为56.7％,组间比较差异无统计学意义（P＞0.05）.至治疗结束,两组PANSS总分及分量表分均较治疗前明显下降,差异均有统计学意义（P＜0.01）.与单用组比较,联用组治疗后2周末、4周末、8周末、12周末一般病理分下降更明显,治疗后12周末阴性症状分下降尤明显,差异均有统计学意义（P＜0.05）.联用组不良反应发生率为20.2％,单用组为57.6％,组间比较差异有统计学意义（P＜0.05）.结论 阿立哌唑联用米氮平治疗难治性精神分裂症的疗效与氯氮平相当,但不良反应发生率低,安全性高.

A clinical study of aripiprazole combined with mirtazapine for treating the treatment resistant schizophrenia

Objective To compare the aripiprazole combined with mirtazapine to clozapine for the clinical efficacy and safty in treating the treatment resistant schizophrenia （TRS）. Metheds One hundred and twenty patients with TRS were divided into the group 1 （aripiprazole combined with mirtazapine, n=60） and group 2 （clozapine, n=60）. The treatment duration was 12 weeks. Positive and Negative Symtoms Scale （PANSS） and Global Clinical Impression （CGI） were used to evaluate the efficacy. Treatment Emergent Symptom Scale （TESS） was utilized to assess the incidence of adverse reaction. Results The effective rates of group 1 and group 2 were 58.3% and 56.7%, respectively, there was no significant difference. At the end of the treatment, the total scores and sub-scores of PANSS were significantly reduced in two groups （P〈0.01）. In 2, 4, 6, and 12 weeks the general psychopathological scores in group 1 decreased significantly as compared with group 2, and in 12 weeks the negative symptoms scores in group 1 were significantly lower than those in group 2 （P〈0.05）. The incidence of the adverse reaction of group 1 was 20.2%, which was significantly lower than that （57.6%） of group 2 （P〈0.05）. Conclusion The thrapy efficiency of aripiprazole combined with mirtazapine is similar to the efficiency of eolzapine in treating TRS. But the incidence of the adverse reaction of aripiprazole combined with mirtazapine is obviously lower than that of colzapine.