摘要
目的了解无抽搐电休克治疗(MECT)合并利培酮对难治性精神分裂症(TRS)的疗效与不良反应。方法对69例符合TRS的患者随机分为研究组34例和对照组35例,前者给予利培酮合并MECT治疗,后者单用利培酮治疗,观察12周。分别于入组前、治疗4周末、8周末和12周末时采用阳性症状和阴性症状量表(PANSS)及大体功能评定量表(GAF)评定疗效,不良反应症状量表(TESS)评定副反应。治疗前后威斯康辛卡片分类测验(WCST)评定认知功能。结果最终纳入分析67例,研究组脱落2例。两组治疗前比较,差异无统计学意义(P>0.05);两组第4周、第8周、第12周末的PANSS总分及各因子分、GAF评分分别与自身治疗前相比,除第4周末对照组的阳性症状、阴性症状分外,差异均有统计学意义(P<0.05或P<0.01)。第12周末研究组与对照组比较,PANSS总分、阳性症状、一般精神病理症状因子分的减分率、GAF评分的增加值及WCST的总测验次数、持续错误数的差异均有统计学意义(P<0.05或P<0.01);研究组PANSS减分率(45.34±15.23)%,临床总有效率56.25%,对照组PANSSS减分率(37.14±17.19)%,临床总有效率31.43%,两组的差异有统计学意义(P<0.05)。两组各时点的TESS评分差异无统计学意义(P>0.05)。结论与单一的利培酮治疗比较,利培酮合并MECT能提高TRS的疗效,且未增加不良反应。
Objective To investigate the efficacy and side effects of modified electroconvulsive therapy（MECT） together with risperidone in treating treatment-resistant schizophrenia （TRS）. Methods Sixty nine inpatients with treatmcnt-resistant schizophrenia were randomly assigned to receive MECT combine rispcridone（ n = 34 ）or rispcridone （n = 35 ） for 12 weeks. The Positive and Negative Syndrome Scale（PANSS）, Global Assessment Function （GAF） and Treatment E- mergent symptoms scale （TESS） were used to measure therapeutic efficacy and side effects. Wisconsin card sorting test （WCST） was used to evaluate cognitive functions prior to and post the treatment. Results Pre-treatment PANSS,GAF, TESS scores and WCST did not differ between the two groups. The PANSS scores decreased and GAF increased significantly in both groups after 4,8,12 week treatment（ P 〈0.0 or P 〈0.01 ）. The decreasing ratio of PANSS-P（ positive scale） ,PANSS-T（ total score） , PANSS-G （general psychopathology scale） , the increasing ratio of GAF scores, total trials and persevera- tive errors（PER） of WCST were more obvious in MECT together with risperidone group than in risperidone group at the end of week 12 （P 〈 0. 05 or P 〈 0. 01 ）. There were significant differences in the decreasing rates of PANSS score [ （45.34 ±15.23） % vs （37.14 ±17. 19） % ] and the response rates （56. 25% vs 31.43% ） between the two groups （ P 〈 0. 05 ）. TESS scores did not differ between the two groups. Conclusions Combination of MECT with risperidone can improve effects in treating TRS and do not increase the side effects.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2009年第2期79-83,共5页
Chinese Journal of Nervous and Mental Diseases
关键词
无抽搐电休克治疗
利培酮
难治性精神分裂症
Risperidone
Modified electroconvulsive therapy
Treatment-resistant schizophrenia
