喹硫平联合舍曲林治疗精神分裂症患者伴强迫症状对照研究

目的 探讨喹硫平联合舍曲林治疗精神分裂症患者伴强迫症状的临床疗效与安全性.方法 将90例精神分裂症伴强迫症状患者随机分为两组,每组45例,两组均口服喹硫平治疗,研究组联合舍曲林治疗,观察8周.于治疗前及治疗第2周、4周、8周末采用阳性与阴性症状量表评定精神症状,Yale Brown强迫症状量表评定强迫症状,副反应量表评定不良反应.结果 治疗后两组阳性与阴性症状量表及Yale Brown强迫症状量表评分均较治疗前显著下降,研究组治疗4周、8周末Yale Brown强迫症状量表总分及强迫思维、强迫行为维度分均较对照组下降更显著(P＜0.05或0.01);研究组改善精神症状总有效率达65.91%、改善强迫症状总有效率达86.37%,对照组分别为65.12%、55.81%,研究组改善精神症状总有效率与对照组比较差异无显著性(u=0.02,P＞0.05),改善强迫症状总有效率显著高于对照组(u=4.83,P＜0.01).两组不良反应均轻微,主要表现为嗜睡、头晕等,发生率差异无显著性(χ2=0.79,P＞0.05).结论 喹硫平联合舍曲林治疗精神分裂症患者伴强迫症状疗效显著,不增加不良反应,安全性高,显著优于单用喹硫平治疗.

A control study of quetiapine plus sertraline in the treatment of schizophrenia with obsessive-compulsive symptoms

Objective To explore the clinical efficacy and safety of quetiapine plus sertraline in the treatment of schizophrenia with obsessive-compulsive symptoms. Methods Ninety schizophrenics with obsessive-compulsive symptoms were randomly divided into two groups of 45 patients each, both groups took orally quetiapine, research group was plus sertraline for 8 weeks. Mental symptoms were assessed with the Positive and Negative Syndrome Scale （PANSS）, obsessive-compulsive symptoms with the Yale-Brown Obsessive Compulsive Scale （Y-BOCS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 2^nd, 4^th and 8^th week. Results After treatment the PANSS and Y-BOCS scores of both groups lowered more significantly compared with pretreatment, so did the to- tal, obsessional thoughts and compulsive behavior scores in the research than in the control group at the end of the 4^th and 8^th week （P〈0.05 or 0.01） ; total effective rates of improving mental and obsessive-com- pulsive symptoms were respectively 65.91% and 86.37% in the research and 65.12% and 55.81% in the control group, those of improving mental symptoms had no significant differences （u=0.02,P〉0.05）, and those of improving obsessive-compulsive symptoms were significantly higher in the research than in the control group （u=4.83,P〈0.01）. Adverse reactions of both groups were mild and mainly hypersomnia and dizziness and so on, their incidences had no significant differences between two groups （X^2 =0.79,P〉 0.05）. Conclusion A combination of quetiapine and sertraline has a significant curative effect on schizo- phrenics with obsessive-compulsive symptoms, doesn＇t increase adverse reactions, has higher safety and is better than single quetiapine treatment.