度洛西汀短期治疗精神分裂症的增效作用及对认知损害变化的影响

发布时间：2018-05-20 02:02

本文选题：度洛西汀 + 氯氮平　；参考：《中国新药与临床杂志》2017年05期

【摘要】：目的探讨度洛西汀对阴性症状为主的精神分裂症患者临床疗效的增效作用、安全性和对认知损害的影响。方法将40例以阴性症状为主的精神分裂症患者随机分为研究组(氯氮平联合度洛西汀治疗)和对照组(单用氯氮平治疗)各20例,疗程8周,采用阳性和阴性症状量表(PANSS)评定疗效变化,采用Stroop色词测验(SCWT)、连线测验(TMT)A和B、词语和语义流畅性、威期康星卡片分类测验(WCST)评价认知功能变化,治疗中需处理的不良反应采用副反应量表(TESS)评定其安全性。结果经重复测量方差分析,两组的PANSS量表中阳性因子分、阴性因子分和总分的时间主效应,分组主效应,时间与分组交互效应差异均有显著意义(P0.05或P0.01)。两组间不良反应发生率及TESS评分均无显著差异(P0.05)。治疗8周后,两组SCWT(Z=-3.468,P=0.001)和TMT-B(Z=-2.083,P=0.037)与治疗前相比具有显著差异;研究组语义流畅性测试优于对照组(Z=-2.137,P=0.033),其余各认知量表评分的组间无显著差异(P0.05)。结论度洛西汀合并氯氮平治疗阴性症状为主的精神分裂症患者的疗效优于单用氯氮平,在短期内能起到一定增效作用,对认知损害症状有部分改善作用。
[Abstract]:Objective to investigate the efficacy, safety and cognitive impairment of doloxetine in patients with schizophrenia with negative symptoms. Methods 40 schizophrenic patients with negative symptoms were randomly divided into study group (20 cases treated with clozapine combined with doxetine) and control group (20 cases treated with clozapine alone) for 8 weeks. Positive and negative symptom scale (PANSS) was used to evaluate the change of curative effect, Stroop color word test was used to evaluate cognitive function, line test was used to test TMTA and B, word and semantic fluency, and WCSTs were used to evaluate cognitive function. Side effects were evaluated by TESS. Results by repeated analysis of variance, there were significant differences in positive factor score, negative factor score and total score, group main effect, time and group interaction effect between the two groups (P0.05 or P0.01). There was no significant difference in the incidence of adverse reactions and TESS score between the two groups (P 0.05). After 8 weeks of treatment, there were significant differences between the two groups in terms of SCWT-3.468 P0. 001) and TMT-BX ZT- 2.083P0. 037), the semantic fluency test in the study group was better than that in the control group (P < 0. 05), and there was no significant difference between the other cognitive scale scores (P 0. 05), and the semantic fluency test in the study group was superior to that in the control group (P < 0. 05). Conclusion Duloxetine combined with clozapine is more effective than clozapine alone in the treatment of schizophrenia with negative symptoms. It can play a synergistic effect in the short term and can partly improve the cognitive impairment symptoms.
【作者单位】：赣州市第三人民医院临床门诊部;
【基金】：赣州科技计划项目(GZ2014ZSF341)
【分类号】：R749.3

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