阿立哌唑联合利培酮对缓解精神分裂症患者暴力行为的影响

目的探讨阿立哌唑联合利培酮对缓解精神分裂症患者暴力行为的影响。方法前瞻性选取2018年3月至2019年12月武汉大学人民医院收治的176例精神分裂症患者为研究对象,根据随机数字表法将样本分为观察组与对照组,每组各88例。观察组予以阿立哌唑、利培酮联合治疗,对照组予以利培酮,2周为1个疗程,共治疗4个疗程。分别在治疗前、治疗后8周采用阳性症状和阴性症状量表(PANSS)评估患者症状改善情况,依据世界卫生组织生存质量测定量表简表(WHOQL-BREF)、韦氏成人智力量表评估生活质量改善情况及认知功能。于治疗前、治疗后2、8周采用《修订版外显攻击行为量表》(MOAS)评估2组患者攻击行为,统计治疗期间的不良反应。结果治疗后8周,观察组阳性症状(12.6±2.7)分,阴性症状(13.5±2.4)分,一般精神病理(21.7±2.6)分,均显著高于对照组[(15.3±2.4)、(15.6±2.3)、(23.5±2.3)分],差异有统计学意义(P<0.05);治疗后8周,2组生活质量评分较治疗前显著提高,观察组心理、社会关系、环境评分依次为(53.2±4.8)、(63.6±5.1)、(56.5±3.4)分,均显著高于对照组[(44.6±3.7)、(58.2±4.6)、(48.4±3.2)分],差异有统计学意义(P<0.05),但2组生理评分比较,差异无统计学意义(P>0.05);治疗后8周,观察组认知功能中言语评分(103.5±14.6)分,与对照组[(99.7±6.5)分]比较,差异无统计学意义(P>0.05),但操作评分(102.7±9.4)分则显著高于对照组[(96.5±7.8)分],差异有统计学意义(P<0.05)。治疗后2周,观察组财产、自身、体力等暴力攻击行为及总评分均显著低于对照组,差异有统计学意义(P<0.05),治疗后8周,观察组各项暴力攻击行为评分均显著低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为2.27%,与对照组不良反应发生率(7.95%)比较,差异无统计学意义(P<0.05)。结论阿立哌唑联合利培酮治疗有助于提高精神分裂症患者生活质量及认知功能,改善其暴力攻击行为。

Curative effects of aripiprazole combined with risperidone on alleviating violent acts in schizophrenia patients

Objective To investigate the effect of aripiprazole combined with risperidone on alleviating violent acts in patients with schizophrenia.Methods One hundred and seventy-six patients with schizophrenia admitted to People's Hospital of Wuhan University from March 2018 to December 2019 were selected as subjects prospectively.According to the random table,the samples were divided into an observation group and a control group,each group 88 cases.The observation group was treated with aripiprazole and risperidone.In the control group,risperidone was given in a 2-week course of treatment for a total of 4 courses of treatment.Positive symptoms and negative symptom scale(PANSS)were used to evaluate the improvement of patients'symptoms before and after the treatment.Improvement in quality of life and cognitive function were assessed using WHOQL-BREF and wechsler adult intelligence scales.The modified explicit aggressive behavior scale(MOAS)was used to evaluate the aggressive behavior of the two groups of patients before the treatment,after 2 weeks,8 weeks of the treatment,and the adverse reactions during the treatment were counted.Results After 8 weeks of the treatment,positive symptoms(12.6±2.7)points,negative symptoms(13.5±2.4)points and general psychopathology(21.7±2.6)points were significantly higher in the observation group than in the control group[(15.3±2.4)points,(15.6±2.3)points and(23.5±2.3)points],the differences were statistically significant(P<0.05).After 8 weeks of the treatment,the scores of quality of life in the two groups were significantly higher than those before the treatment.The scores of psychological,social relationship and environment in the observation group were(53.2±4.8)points,(63.6±5.1)points and(56.5±3.4)points respectively,which were significantly higher than those in the control group[(44.6±3.7)points,(58.2±4.6)points and(48.4±3.2)points],the differences were statistically significant(P<0.05).After 8 weeks of the treatment,the score of speech(103.5±14.6)in the observation group was not significantly different from that of the control group(99.7±6.5)(P>0.05),but the score of operation(102.7±9.4)points was significantly higher than that of the control group(96.5±7.8)points,the differences were statistically significant(P<0.05).After 2 weeks of the treatment,the scores of violent attacks on property,self and physical strength in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).After 8 weeks of the treatment,the scores of violent attacks in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 2.27%,compared with the incidence of adverse reactions in the control group(7.95%),the difference was not statistically significant(P>0.05).Conclusion The treatment of aripiprazole combined with risperidone can improve the life quality and cognitive function of schizophrenia patients,and reduce their acts of violent attacks.