[1]刘旭恩,沈　姣,张美霞.阿立哌唑联合无抽搐电休克治疗女性难治性精神分裂症疗效观察[J].新乡医学院学报,2017,34(9):847-850.[doi:10.7683/xxyxyxb.2017.09.018]
　LIU Xu-en,SHEN Jiao,ZHANG Mei-xia.Efficacy of aripiprazole combined with modified electroconvulsive therapy in treatment of female refractory schizophrenia[J].Journal of Xinxiang Medical University,2017,34(9):847-850.[doi:10.7683/xxyxyxb.2017.09.018]
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阿立哌唑联合无抽搐电休克治疗女性难治性精神分裂症疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年9
页码:
847-850
栏目:
临床研究
出版日期:
2017-09-05

文章信息/Info

Title:
Efficacy of aripiprazole combined with modified electroconvulsive therapy in treatment of female refractory schizophrenia
作者:
刘旭恩; 沈　姣; 张美霞
（新乡医学院第二附属医院早期干预一科，河南　新乡　453002）
Author(s):
LIU Xu-en; SHEN Jiao; ZHANG Mei-xia
（Department of Early Intervention，the Second Affiliated Hospital of Xinxiang Medical University，Xinxiang 453002，Henan Province，China）
关键词:
阿立哌唑; 无抽搐电休克; 女性; 难治性精神分裂症
Keywords:
aripiprazole; modified electroconvulsive therapy; female; refractory schizophrenia
分类号:
R749.3
DOI:
10.7683/xxyxyxb.2017.09.018
文献标志码:
A
摘要:
目的　探讨阿立哌唑联合无抽搐电休克（MECT）治疗女性难治性精神分裂症临床疗效及不良反应。方法　将新乡医学院第二附属医院2014年7月至2016年5月收治的女性难治性精神分裂症患者105例分为对照组和观察组，对照组52例给予阿立哌唑口服治疗，观察组53例给予阿立哌唑联合MECT治疗。2组患者均治疗8周。采用阳性与阴性症状量表（PANSS）评定临床疗效；采用韦氏记忆量表（WMS） 评定MECT对记忆的影响；采用药物不良反应量表（TESS）评定2组患者治疗后不良反应发生情况。结果　最终纳入分析的患者103例，观察组脱落2例，对照组无脱落。治疗前2组患者PANSS评分比较差异无统计学意义（P>0.05）；2组患者治疗第2周末的阳性症状评分、一般精神病理及PANSS总分均较治疗前显著降低（P<0.05）；在治疗4、8周末，2组患者阴性症状评分、阳性症状评分、一般精神病理评分及PANSS 总分均较治疗前显著降低 （P<0.05，P<0.01）。治疗4周末，观察组患者阳性症状评分、一般精神病理评分、PANSS总分显著低于对照组 （P<0.05）；治疗8周末，观察组患者阴性症状评分、阳性症状评分、一般精神病理评分及PANSS 总分显著低于对照组（P<0.05）。治疗8周末，观察组和对照组患者PANSS减分率分别为 （39.89±8.62）%和 （31.97±8.17）%，观察组和对照组患者治疗总有效率分别为 66.67%和48.08%，观察组患者PANSS减分率和治疗总有效率均显著高于对照组（P<0.05）。治疗2周末，观察组患者WMS评分较治疗前显著降低（P<0.05）；治疗4周末，WMS中图片因子评分低于治疗前（P<0.05）；治疗8周末，WMS各因子评分与治疗前比较差异无统计学意义（P>0.05）。2组患者治疗后TESS评分及不良反应发生率比较差异均无统计学意义（P>0.05）。结论　与单一应用阿立哌唑相比，MECT联合阿立哌唑可显著提高女性难治性精神分裂症患者的治疗效果，且不增加不良反应。
Abstract:
Objective　To investigate the efficacy and side effects of aripiprazole combined with modified electroconvulsive therapy （MECT） in the treatment of female refractory schizophrenia.Methods　One hundred and five female refractory schizophrenia patients in the Second Affiliated Hospital of Xinxiang Medical University from July 2014 to May 2016 were selected and divided into control group and observation group.Fifty-two patients in the control group were treated with aripiprazole.In the observation group，53 patients were treated with aripiprazole combined with MECT.All the patients were treated for eight weeks.Clinical efficacies were assessed with the positive and negative syndrome syndrome scale（PANSS）；Wechsler memory scale （WMS） were used to evaluate the effect of MECT on memory.Adverse drug reactions were evaluated by treatment emergent symptom scale（TESS）before and after treatment in both groups.Results　There was no significant difference in PANSS scores between the two groups before treatment （P>0.05）.The positive symptom scores，the general mental pathology scores and the PANSS total scores in the two groups at the end of the second week were significantly lower than before treatment（P<0.05）；at the end of fourth and eighth week of treatment，the negative symptom scores，the positive symptom scores，the general psychopathological scores and the PANSS total scores of the two groups were significantly lower than those before treatment （P<0.05 or P<0.01）.The positive symptoms，the general psychopathological scores and the PANSS total score in the observation group were significantly lower than those in the control group at the end of fourth week of treatment （P<0.05）.At the end of the eighth week of treatment，the negative symptom scores，the positive symptom scores，the general psychopathological scores and the PANSS total scores in the observation group were significant lower than those in the control group （P<0.05）.At the end of the eighth week of treatment，the decreasing rates of PANSS score in the observation group and control group were （39.89±8.62）% and （31.97±8.17）%，and the total effective rates were 66.67% and 48.08%，respectively.The decreasing rates of PANSS score and total effective rates in the observation group were higher than those in the control group （P<0.05）.The WMS score of the observation group decreased more significantly at the end of the second week of treatment compared with that before treatment；at the end of the fourth week of treatment，the score of the picture was louer than that before treatment(P<0.05)；but there was no significant difference in WMS score between that at the end of the eighth week and before treatment（P>0.05）.There was no significant difference between the two groups in the TESS score and adverse reaction rate （P>0.05）.Conclusion　Compared with single application of aripiprazole，MECT combined with aripiprazole can significantly improve effects in treating female refractory schizophrenia and it can not increase the side effects.

参考文献/References:

［1］　CARPENTER W T，BUCHANAN R W.Special section on implications of CATIE：lessons to take home from CATIE［J］.Psychiatric Services，2008，59（5）：523-525.
［2］　BITTER I，DOSSENBACH M R K，BROOK S，et al.Olanzapine versus clozapine in treatment-resistant or treatment-intolerant schizophrenia［J］.Prog Neuropsychopharmacol Biol Psychiatry，2004，28（1）：173-180.
［3］　PETRIDES G，MALUR C，BRAGA R J，et al.Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia：a prospective，randomized study［J］.Am J Psychiatry，2015，172（1）：52-58.
［4］　VOULGARI C，GIANNAS R，PATERAKIS G，et al.Clozapine-induced late agranulocytosis and severe neutropenia complicated with Streptococcus pneumonia，venous thromboembolism，and allergic vasculitis in treatment-resistant female psychosis［J］.Case Rep Med，2015，2015：703218.
［5］　ZIEGENBEIN M，SIEBERER M，CALLIESS I T，et al.Combination of clozapine and aripiprazole：a promising approach in treatment-resistant schizophrenia［J］.Aust N Z J Psychiatry，2005，39（9）：840-841.
［6］　范肖冬，汪向东，于欣，等.ICD-10精神与行为障碍分类［M］.北京：人民卫生出版社，1993：72-76.
［7］　KANE J M.Treatment-resistant schizophrenic patients［J］.J Clin Psychiatry，1995，57：35-40.
［8］　马骏，孙梦夕，张琳，等.首发精神分裂症患者治疗效果与血清炎性因子水平变化关系研究［J］.新乡医学院学报，2017，34（2）：113-116.
［9］　NASRALLAH H A.Treatment-refractory schizophrenia：a clinical conundrum［J］.J Clin Psychiatry，2015，76（9）：1142.
［10］　BURRIS K D，MOLSKI T F，XU C，et al.Aripiprazole，a novel antipsychotic，is a high-affinity partial agonist at human dopamine D2 receptors［J］.J Pharmacol Exp Ther，2002，302（1）：381-389.
［11］　王兵华，曾德志，樊学文，等.无抽搐电休克治疗——无抽搐电休克对难治性精神分裂症的增效作用［J］.临床精神医学杂志，2008，18（6）：415-417.
［12］　JIANG Y，ZHANG H，WANG Z，et al.Effects of modified electroconvulsive therapy on the cognitive function and blood parameters in female patients with schizophrenia［J］.Int J Clin Exp Med，2015，8（1）：1349-1355.
［13］　刘淑华，谭余龙.无抽搐电休克治疗对精神分裂症患者记忆力的影响［J］.黑龙江医学，2008，32（2）：107-108.

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更新日期/Last Update: 2017-09-05