消幻汤合并利培酮对精神分裂症模型小鼠旷场行为的影响

目的：观察消幻汤合并利培酮治疗后的精神分裂症小鼠在旷场自主活动和探究行为的变化。方法昆明小鼠60只随机分为五组,空白组、模型组、利培酮组、消幻汤组及消幻汤合并利培酮组（合并组）,每组12只。腹腔注射MK-801每日0.36 mg/kg,连用2周,制作精神分裂症小鼠模型。造模成功后,采用灌胃方式,分别给予利培酮组、消幻汤组及合并组相应药物;模型组和空白组给予生理盐水,连续给药4周。采用旷场观察五组的自主活动和探究行为的变化。结果利培酮组、消幻汤组和合并组与模型组相比,活动总路程、外周区和中央区活动路程以及3个时间段的活动路程均不同程度减少（P<0.05）;利培酮组与消幻汤组相比,仅外周区活动路程减少（P<0.05）;合并组与消幻汤组相比,活动总路程、外周区活动路程和T1时间活动路程明显减少（P<0.01或P<0.05）;合并组与利培酮组相比,各活动路程测定值均有减少,但差异无统计学意义（P>0.05）。结论消幻汤合并利培酮对精神分裂症模型小鼠自主活动和探究行为的增多具有明显的抑制作用。在相同时间内消幻汤合并利培酮使用控制精神分裂症模型小鼠的紊乱行为优于单独使用消幻汤。     

不同抗精神病药物对男性精神分裂症患者性功能的影响

目的 观察不同抗精神病药物对男性精神分裂症患者性功能的影响,了解患者性功能与所服药物的关系.方法 选取单一服用不同抗精神病药物的精神分裂症患者412例及健康普通男性296例,采用勃起功能国际问卷和生活质量综合评定问卷进行调查.结果 412例患者服药期间性功能障碍的发生率较高（37. 9％）,与正常对照组（8 .8％）比较差异有统计学意义（P＜0.05）,服用不同药物之间性功能障碍发生率的差异有统计学意义（P＜0.05）;Logistic回归分析显示服用抗精神病药物是发生性功能障碍的主要危险因素.结论 男性精神分裂症患者的性功能障碍发生率高,抗精神病药物是主要危险因素.     

Increased [3H] raclopride binding sites in postmortem brains from schizophrenic violent suicide victims

The specific binding of the D₂-dopamine receptor antagonist radioligand [³H] raclopride was quantitated in the postmortem caudate and frontal cortex from schizophrenic suicide victims and control subjects. In schizophrenic suicides the density of binding sites (B_max) was higher (40%,P<0.05) in the caudate, whereas it did not change in the cortex as compared to those in controls. The apparent dissociation constants (K _d ) were also found increased both in caudate (24%) and cortex (75%) from schizophrenics, but these apparent decreases in receptor affinity did not reach statistical significance. The mean B_max value in drug-free schizophrenic suicides (n=3) did not differ from the B_max value in neuroleptic drug-treated schizophrenics (n=7) but it was found increased in respect to control subjects (n=9). No differences in [³H] raclopride binding were observed between non-schizophrenic suicide victims (n=4) and matched controls (n=4), suggesting that the modifications of D₂-dopamine receptors in schizophrenia are not related to suicide.     

六郁汤对奥氮平致精神分裂症患者代谢综合征的改善作用

目的:探讨六郁汤对奥氮平致精神分裂症患者代谢综合征的改善作用。方法:选取2015年1月至2017年1月恩施州精神卫生中心收治的精神分裂症合并代谢综合征患者120例,随机分为观察组与对照组,每组60例,观察组采用奥氮平联合六郁汤治疗,对照组给予奥氮平治疗,2组均治疗12周。比较2组患者临床疗效;比较治疗前后2组患者糖脂代谢指标、体重指数、血压变化;比较2组患者精神症状改善情况;统计2组患者治疗期间不良反应发生情况。结果:治疗后观察组的总有效率(93.33%),显著高于对照组(71.67%)(P0.01);与治疗前比较,观察组血清FPG、HbAlc、TG水平及BMI均降低,且低于对照组(P0.05或P0.01);观察组血清HDL水平升高,且高于对照组(P0.01),治疗后观察组DBP、SBP均较治疗前降低,且低于对照组(P0.05或P0.01),治疗后2组患者PANSS评分及观察组TESS评分均较治疗前下降,且观察组低于对照组(P0.05或P0.01)。结论:六郁汤可有效改善奥氮平致精神分裂症代谢综合征患者糖脂代谢,有效调节患者血压,并改善其精神症状,安全性良好。     

伴精神病性症状躁狂症的临床研究

目的 :探讨伴精神病性症状躁狂症的临床特点。方法 :对 5 4例不典型躁狂症及 12 4例典型(包括较典型 )躁狂症的一般人口学资料及首发年龄、家族史、临床症状、疗效、再入院诊断作统计分析 ,比较其异同。结果 :不典型躁狂症占 30 .3% ,以女性居多 ,发病年龄较晚 ,病前个性内向居多 ,心理素质较差。14.8%再入院改诊为精神分裂症。结论 :不典型躁狂症可能是躁狂症的一种亚型 ,对这类病人应加强随访、缩短随访期 ,系统地合并抗精神分裂症药物治疗。     

A scale for detection of negative attitudes towards medication among relatives of schizophrenic patients

The validity of a questionnaire developed to assess negative attitudes towards drug therapy by relatives of schizophrenic patients is examined. The questionnaire items are tested against the statement: "Patients should not take drugs, they can only be helped by good advice". The prejudice of relatives of schizophrenics against drug therapy may have an effect on the patients' compliance to maintenance therapy and, subsequently, on their relapse rate. A number of factors, social and psychological, were examined as possible determinants of the negative attitudes of relatives. These factors include age, sex, profession, education, positive family history, and use of drugs among the relatives; mental state, residence, duration of illness, relapse rate and clinical features in the patients. Poor education of relatives correlated to negative attitudes towards drug therapy.     

奥派对精神分裂症患者认知功能的影响

目的 探讨奥派治疗对分裂症患者认知功能的影响。方法 以入院顺序分层随机法．将奥派与维思通治疗精神分裂症各40例作对照研究,在治疗前和治疗后2、4、8、12周末,用阳性症状及阴性症状量表（PANSS）．不良反应量表（TESS）评定疗效及副反应,用韦氏成人智力量表（WAIS—R）、韦氏记忆量表（WMS）和威斯康星卡片分类测验（WCST）评定治疗前后患者认知功能的改变。分析量表中备领域的计分。结果 两组PANSS总分在治疗后与治疗前比较有显著性差异（P〈0．01）．奥派组有效率92．5％,显效率80％;维思通组有效率90％,显效率80％。两组间疗效无显著性差异（P〉0．05）．且两组言语量表、操作量表、全量表和记忆量表分比治疗前明显提高。治疗后8、12周末TESS评分,研究组均低于对照组．有显著性差异（P〈0．01）。结论 奥派治疗精神分裂症疗效确切,且安全性高,对认知功能的改善彻底。     

Cardiovascular and metabolic risk in outpatients with schizophrenia treated with antipsychotics: results of the CLAMORS Study

AIM: To assess the prevalence of Coronary Heart Disease (CHD) and Metabolic Syndrome (MS) in patients treated with antipsychotics. METHODS: Retrospective, cross-sectional, multicenter study in which 117 Spanish psychiatrists (the CLAMORS Study Collaborative Group) recruited consecutive outpatients meeting DSM-IV criteria for Schizophrenia, Schizophreniform or Schizoaffective Disorder, receiving antipsychotic treatment for at least 12 weeks. CHD risk was assessed by SCORE (10-year CV death) and Framingham (10-year all CHD events) function. MS was defined by at least 3 of the following components: waist circumference >102 (men)/>88 (women) cm; triglycerides > or =150 mg/dl; HDL-cholesterol <40 mg/dl (men)/<50 mg/dl (women); blood pressure > or =130/85; fasting glucose > or =110 mg/dl. RESULTS: 1452 evaluable patients (863 men, 60.9%), aged 40.7+/-12.2 years (mean+/-SD) were included. MS was present in 24.6% [23.6% (men), 27.2% (women); p=0.130)]. The overall 10-year risks were 0.9+/-1.9 (SCORE) and 7.2+/-7.6 (Framingham). 8% (95%CI: 6.5-9.5) and 22.1% (95%CI: 20.0-24.3) of patients showed a high/very high risk according to SCORE (> or =3%) and Framingham (> or =10%) function. Abdominal obesity and low HDL-cholesterol were more prevalent in women: 54.5% (95%CI: 50.2-58.9) versus 34.3% (95%CI: 31.0-37.7), and 46.1% (95%CI: 41.4) versus 28.5 (95%CI: 50.8), p<0.001 in both cases. Hypertension and hypertriglyceridemia were more prevalent in men: 59.0% (95%CI: 55.7-62.3) versus 46.0% (95%CI: 41.8-50.2), and 40.7% (95%CI: 37.2-44.2) versus 32.4 (95%CI: 28.3-36.5), p<0.01 in both cases. CONCLUSIONS: CHD risk and MS prevalences among patients with schizophrenia treated with antipsychotics were in the same range as the Spanish general population 10 to 15 years older.     

住院精神分裂症患者抗精神病药物使用情况调查

目的 了解住院精神分裂症患者抗精神病药的使用情况,了解影响精神分裂症患者用药的因素.方法 采用横断面方法对住院精神分裂症患者使用药物的情况进行调查.结果 本次调查465例患者涉及47种药物治疗方案,使用1种抗精神病药物175例(37.6%),联用2种种抗精神病药物262例(56.3%),联用3种种抗精神病药物28例(6.0%),联用2种抗精神病药物治疗在住院患者中非常多见;氯氮平使用率和处方占有率排在第一,非典型抗精神病药物已占精神分裂症治疗用药的主导地位;公费医疗患者选择非典型抗精神病药物明显高于非公费医疗患者.结论 在精神分裂症治疗用药中,非典型抗精神病药物逐渐取代了典型抗精神病药物,并且患者费用支付方式影响抗精神病药物的选择.     

利培酮与氯丙嗪治疗精神分裂症患者的心电图对比分析

目的探讨单一使用利培酮、氯丙嗪治疗精神分裂症过程中,心电图改变的特征及其与服药时间、剂量之间的对比分析。方法将符合CCMD-3精神分裂症的244例住院患者,分为利培酮治疗组和氯丙嗪治疗组,在服药过程中,分别于服药后第1、2、4、8周定期进行心电图检查,观察心电图的改变情况,并对其异常率进行统计分析。结果 244例患者分为两组,患者心电图均有不同程度的病理改变。应用抗精神分裂症药物治疗八周后利培酮组异常率为36.89%、氯丙嗪组异常率为50.82%,但服用利培酮组异常率显著低于氯丙嗪组(P<0.05)。心电图改变与服药时间的长短存在一定的关系,但与性别、年龄无明显差异。结论利培酮引起的心电图改变,其程度及发生率显著低于氯丙嗪。