拉莫三嗪联合氯氮平对慢性精神分裂症患者临床疗效及生物学影响的研究

目的：探讨应用拉莫三嗪联合氯氮平治疗慢性精神分裂症的临床疗效以及对生物学指标，包括血糖、血脂以总胆固醇（TC）水平计]、体质量及心电图（EKG）的影响。方法：选取某院于2013年6月-2014年6月期间收治的68例慢性精神分裂症患者作为研究对象，并按照随机数字表法将其分为2组，每组34例。对照组患者给予氯氮平以及对症支持治疗，而试验组患者在对照组治疗的基础上加用拉莫三嗪进行治疗。2组患者的疗程均为3个月。治疗后，观察并记录2组患者的临床症状，并在治疗前后检测患者的血糖、TC、体质量、EKG和生活质量评分的变化情况。结果：试验组患者的总有效率为88.24%，显著高于对照组的70.59%（P<0.05）。治疗3个月后，2组患者的精神病理症状评分、阳性症状评分、阴性症状评分和PANSS总分均显著降低，与治疗前相比较差异有统计学意义（P<0.05或P<0.01）；试验组患者在上述各指标方面的改善程度相比对照组更为明显，组间差异有统计学意义（P<0.01）。治疗后，对照组患者血糖、EKG和体质量指标均明显增大，与治疗前相比较差异有统计学意义（P<0.05）；试验组患者的上述指标则稍有降低或未有明显变化，均无统计学意义（P>0.05），但与对照组相比，组间差异有统计学意义（P<0.05）。治疗过程中，2组患者在便秘、心跳过快、静坐不能、白细胞减少、心电图异常和体质量增加方面相比，组间差异有统计学意义（P<0.05或P<0.01）。治疗后，2组患者的生活质量评分相对治疗前均显著提高（P<0.05）；试验组患者生活质量评分的提高程度相比对照组更为明显，组间差异有统计学意义（P<0.05）。结论：拉莫三嗪联合氯氮平治疗慢性精神分裂症的临床效果良好，并能够显著缓解药物治疗的毒副作用及对患者生物学指标影响，同时还对患者的生活质量具有提高的作用，值得临床推广使用。

Clinical and biological effects of lamotrigine combined with clozapine on chronic schizophrenia patients

OBJECTIVE To investigate clinical efficacy and biological parameters of lamotrigine combined with clozapine in treatment against chronic schizophrenia, including blood glucose, blood lipids assessed as total cholesterol (TC), body mass and electrocardiogram (EKG). METHODS Sixty eight chronic schizophrenia patients in our hospital from June 2013 to June 2014 were selected as subjects, and divided into two groups, 34 patients in each group. Patients in control group were given clozapine and symptomatic supportive treatment, while for patients in observation group, lamotrigine was added based on basic treatment of control group. Treatment course of both groups was 3 months. After treatment, clinical symptoms of two groups were observed and recorded, and changes of blood glucose, TC, body mass, EKG and quality of life were measured before and after treatment. RESULTS Total effective rate of observation group was 88.24%, significantly higher than 70.59% of control group (P<0.05). After 3 months of treatment, psychiatric symptoms score, positive symptom score, negative symptom score and PANSS total score were significantly decreased compared with those before treatment (P<0.05 or P<0.01). Improvement degree of patients in observation group was more obvious than that in control group (P<0.01). After treatment, blood glucose, EKG and body mass index were significantly increased in control group compared with those before treatment (P<0.05). The above parameters in patients of observation group had slightly decreased or no significant changes (P>0.05), but significantly different compared with control group (P<0.05). During treatment, two groups of patients had significant difference in constipation, tachycardia, akathisia, WBC, abnormal ECG and body weight (P<0.05 or P<0.01). After treatment, quality of life in both groups significantly improved (P<0.05). Improvement of quality life of patients in observation group was significant than that in control group (P<0.05). CONCLUSION Lamotrigine combined with clozapine has good efficacy in treatment against chronic schizophrenia, and can significantly relieve side effects of drug therapy and effects on biological indexes of patients, improve patient's quality of life, so it is worthy of clinical promotion.