摘要
目的探讨齐拉西酮及心理治疗对伴发抑郁症状精神分裂症患者的疗效及安全性。方法将101例精神分裂症患者随机分为齐拉西酮组(33例)、利培酮组(33例)、齐拉西酮联合心理治疗组(联合组,35例),疗程8周。分别于治疗前及治疗后第2、4、8周末采用阳性和阴性综合征量表(PANSS)、卡尔加里精神分裂症抑郁量表(CDSS)评定疗效,用治疗中需处理的不良反应症状量表(TESS)评定安全性。结果治疗后第4、8周末三组PANSS总分及各因子分均较各自治疗前下降(P<0.05);治疗后第2周末齐拉西酮组和联合组CDSS评分均较各自治疗前下降(P<0.05),治疗后第4、8周末三组CDSS评分均较各自治疗前下降(P<0.05);治疗后第2周末齐拉西酮组、联合组CDSS评分均低于利培酮组(P<0.05),治疗后第8周末齐拉西酮组、利培酮组CDSS评分均高于联合组(P<0.05)。齐拉西酮组和联合组总不良反应发生率低于利培酮组(P<0.05)。结论齐拉西酮治疗精神分裂症疗效与利培酮相当,但在改善抑郁症状时起效更快,安全性更高;合并心理治疗对抑郁症状更有改善作用。
Objective To explore the clinical efficacy and safety of ziprazidone combined with psychotherapy in the treatment of schizophrenia with depressive symptoms. Methods 101 schizophrenic patients were randomly divided into ziprazidone group （ n = 33 ） , risperidone group （ n = 33 ） , ziprazidone combined with psychotherapy group （ combination group, n = 35 ） treated with eorresponding treatment for 8 weeks. Clinical effieacy was assessed with Positive and Negative Syndrome Scale （PANSS） , Calgary Depression Scale for Schizophrenia （CDSS） at baseline and at the end of the 2nd, 4th, 8th week of the treatment. Adverse reaction was assessed with Treatment Emergent Symptom Scale （TESS）. Results Total scores and all factor scores of PANSS at the end of the 4th and 8th week in three groups decreased significantly compared with the baseline （P 〈 0. 05）. Scores of CDSS at the end of the 2nd week in ziprazidone group and combination group decreased significantly compared with the baseline （ P 〈 0.05 ） ;scores of CDSS at the end of the 4＇h and 8＇h week in three groups were significantly lower than those at baseline （P 〈 0.05 ）. Scores of CDSS at the end of the 2＂d week of the treatment in ziprazidone group and combination group were significant＇]y lower than that in risperidone group （P 〈 0.05）. Scores of CDSS at the endpoint in ziprazidone group and risperidone group were significantly higher than that in combination group （P 〈 0.05）. Incidence rates of adverse reactions in ziprazidone group and combination group were significantly lower than that in risperidone group （P 〈 0.05）. Conclusion Ziprazidone has an evident effect equivalent to risperidone in the treatment of schizophrenia;ziprazidone takes effect more quickly at the improvement of depressive symptoms, and has higher safety. When combined with psychotherapy, ziprazidone can improue depressive symptoms better.
出处
《精神医学杂志》
2015年第6期433-436,共4页
Journal of Psychiatry
基金
山东省医药卫生科技发展计划项目(编号:2014WS0114)
关键词
精神分裂症
抑郁症状
齐拉西酮
利培酮
心理治疗
Schizophrenia Depressive symptoms Ziprazidone Risperidone Psychotherapy
