阿立哌唑联用坦度螺酮对女性精神分裂症患者认知功能的影响
发布时间：2018-09-03 17:40
【摘要】：目的：探讨阿立哌唑与坦度螺酮联用对女性精神分裂症患者认知功能的影响。 方法：采用随机对照研究,将100例女性精神分裂症患者随机分成两组,研究组(阿立哌唑联用坦度螺酮),对照组(阿立哌唑),阿立哌唑起始剂量15mg/d,两周后加至治疗剂量20mg/d,最大剂量30mg/d。坦度螺酮起始剂量5mg/d,两周后加至治疗剂量,最大剂量为30mg/d。治疗8周,在治疗前、治疗后分别做阳性与阴性症状量表(Positive and Negative Syndrome Scale, PANSS)、威斯康星卡片分类测验(Wisconsin Card Sorting Test, WCST)以及精神分裂症认知功能成套测验共识版(MATRICS Consensus Cognitive in Schizophrenia MCCB)进行疗效分析和认知功能评定。同时给予副作用量表(Treatment Emergent Symptom Scale, TESS)评定检测药物的副作用。所有的数据用SPSS17.0进行统计分析。 结果：(1)研究组纳入47例,脱落3例。对照组纳入44例,脱落6例。基线时两组间患者的发病年龄,首次住院年龄,病程、目前年龄以及受教育程度、PANSS各项评分以及各项认知测验评分无显著性差异。两组患者的疗效指标PANSS评分在治疗结束时与基线比较均显著降低(P均0.01),但两组同一时点比较无统计学差异。 (2)对两组患者治疗前后精神分裂症认知功能成套测验共识版(MCCB)各项分值进行组内和组间比较发现,研究组和对照组持续操作能力测验(CPT-IP)、符号编码(SC)、言语记忆(HVLT-R)、数字序列(DS)、视觉记忆(BVMT-R)、言语流畅性(CF)、情绪管理能力(MSCEIT-ME)有所改善(P0.01或0.05),且研究组较对照组同一时点比较持续操作能力测验(CPT-IP)、符号编码(SC)、言语记忆(HVLT-R)、数字序列(DS)、言语流畅性(CF)改善更显著,两组间比较有统计学意义(P均0.05或0.01)。研究组和对照组空间广度(SS)、迷宫测验(NAB-Mazes)言语流畅性(CF)、连线测验(TMT)分值均有改善,但无统计学意义(p0.05)。 (3)对两组患者治疗前后威斯康星卡片分类测验(WCST)进行组内和组间比较发现,研究组和对照组完成分类数(Cc)、正确应答数(Rc)分值增加(p均0.01),错误应答数(Re)、持续性应答数(Rp)、持续性错误数(Rpe)、非持续性错误数(nRpe)分值降低(p0.05或0.01),且增加或降低均有统计学意义。且研究组较对照组同一时点在完成分类数、正确应答数、错误应答数、非持续性错误数4项改善中占有优势(p0.05或0.01)。而完成第一分类所需应答数(Rf),概念化水平应答百分比(Rf%),不能维持完整分类数(FM)、学习到学会(L-L)两组虽然有所改善,但无统计学意义。 (4)副作用比较：治疗过程中,两组均出现不同程度的不良反应。对照组出现兴奋激越的例数明显多于研究组(p0.05),其他副作用差异无显著性。 (5)相关分析结果显示：患者的阳性症状、一般病理症状和各项认知测验结果均无相关性。阴性症状和语言记忆、符号编码、持续操作、情绪管理、数字序列、MCCB总分呈显著相关性(p0.01),与持续性应答、持续性错误呈正相关(p0.01)。附加症状和符号编码、情绪管理呈负相关(p0.05)。PANSS总分和符号编码、情绪管理、语言记忆、MCCB总分呈负相关(p0.01),和持续性应答、持续性错误呈正相关(p0.01)。受教育程度和符号编码、语言记忆、情绪管理、MCCB总分、持续性应答、持续性错误密切相关(p0.05或0.01)。 (6)多元逐步回归分析显示：文化程度、阴性症状为精神分裂症患者的认知功能的主要影响因素。 结论：1.阿立哌唑联用坦度螺酮或单独应用阿立哌唑均可有效改善精神分裂症患者的精神症状。 2.阿立哌唑联用坦度螺酮较单用阿立哌唑改善女性精神分裂症患者的认知功能。 3.受教育程度、阴性症状和PANSS总分与认知功能有显著的相关性。受教育程度、阴性症状为主的精神分裂症患者存在显著的认知障碍。
[Abstract]:Objective: To investigate the effect of aripiprazole combined with tansspirone on cognitive function in female patients with schizophrenia.
Methods: 100 female patients with schizophrenia were randomly divided into two groups: the study group (aripiprazole combined with tamsulosone), the control group (aripiprazole), the initial dose of aripiprazole 15 mg / d, two weeks later to the treatment dose 20 mg / d, the maximum dose 30 mg / D. the initial dose of tamsulosone 5 mg / d, two weeks later to the treatment dose. The maximum dose was 30mg/d for 8 weeks. Positive and Negative Syndrome Scale (PANSS), Wisconsin Card Sorting Test (WCST) and Cognitive Function Test Consensus in Schizophren were administered before and after treatment. IAMCCB was evaluated for efficacy and cognitive function. Treatment Emergent Symptom Scale (TESS) was used to assess the side effects of the drugs. All data were analyzed with SPSS 17.0.
Results: (1) 47 patients were enrolled in the study group, 3 patients were exfoliated, 44 patients in the control group and 6 patients were exfoliated. Compared with baseline, there was a significant decrease (P = 0.01), but there was no significant difference between the two groups at the same time point.
(2) Comparing the scores of cognitive function test consensus version (MCCB) before and after treatment, the study group and the control group showed CPT-IP, SC, HVLT-R, DS, BVMT-R, CF, and emotional management ability. MSCEIT-ME was improved (P 0.01 or 0.05), and the improvement of CPT-IP, SC, HVLT-R, DS, CF was more significant in the study group than in the control group at the same time point. There was significant difference between the two groups (P 0.05 or 0.01). The scores of NAB-Mazes and TMT were all improved, but there was no significant difference (p0.05).
(3) Wisconsin Card Classification Test (WCST) before and after treatment was compared between the two groups. The results showed that the study group and the control group completed classification number (Cc), correct response number (Rc) score increased (p 0.01), error response number (Re), persistent response number (Rp), persistent error number (Rpe), non-persistent error number (nRpe) score decreased (p 0.05 or 0.05). Compared with the control group at the same time point, the study group had an advantage (p0.05 or 0.01) in completing the four improvements of classification number, correct response number, error response number and non-persistent error number, while the response number needed to complete the first classification (Rf), conceptual level response percentage (Rf%) could not maintain the complete classification number (F). M), although the two groups of learning and learning (L-L) improved, but there was no statistical significance.
(4) Side effects: In the course of treatment, there were different degrees of adverse reactions in both groups. The number of cases of excitatory agitation in the control group was significantly higher than that in the study group (p0.05), and there was no significant difference in other side effects.
(5) Correlation analysis showed that the positive symptoms, general pathological symptoms and cognitive test results were not correlated. Negative symptoms and language memory, symbol encoding, continuous operation, emotional management, number sequence, total score of MCCB were significantly correlated (p0.01), and persistent response, persistent error were positively correlated (p0.01). Symbol coding, emotional management was negatively correlated (p0.05). PANSS total score and symbol coding, emotional management, language memory, MCCB total score was negatively correlated (p0.01), and persistent response, persistent error was positively correlated (p0.01). Educational level and symbol coding, language memory, emotional management, MCCB total score, persistent response, persistent error were closely related (p0.05). Or 0.01).
(6) Multivariate stepwise regression analysis showed that educational level and negative symptoms were the main influencing factors of cognitive function in schizophrenic patients.
Conclusion: 1. Aripiprazole combined with tamsulosone or aripiprazole alone can effectively improve the mental symptoms of schizophrenic patients.
2. Aripipiprazole combined with tamsulosone can improve the cognitive function of female schizophrenic patients compared with aripiprazole alone.
3. Educational level, negative symptoms and PANSS scores were significantly correlated with cognitive function. Schizophrenic patients with negative symptoms had significant cognitive impairment.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3
[Abstract]:Objective: To investigate the effect of aripiprazole combined with tansspirone on cognitive function in female patients with schizophrenia.
Methods: 100 female patients with schizophrenia were randomly divided into two groups: the study group (aripiprazole combined with tamsulosone), the control group (aripiprazole), the initial dose of aripiprazole 15 mg / d, two weeks later to the treatment dose 20 mg / d, the maximum dose 30 mg / D. the initial dose of tamsulosone 5 mg / d, two weeks later to the treatment dose. The maximum dose was 30mg/d for 8 weeks. Positive and Negative Syndrome Scale (PANSS), Wisconsin Card Sorting Test (WCST) and Cognitive Function Test Consensus in Schizophren were administered before and after treatment. IAMCCB was evaluated for efficacy and cognitive function. Treatment Emergent Symptom Scale (TESS) was used to assess the side effects of the drugs. All data were analyzed with SPSS 17.0.
Results: (1) 47 patients were enrolled in the study group, 3 patients were exfoliated, 44 patients in the control group and 6 patients were exfoliated. Compared with baseline, there was a significant decrease (P = 0.01), but there was no significant difference between the two groups at the same time point.
(2) Comparing the scores of cognitive function test consensus version (MCCB) before and after treatment, the study group and the control group showed CPT-IP, SC, HVLT-R, DS, BVMT-R, CF, and emotional management ability. MSCEIT-ME was improved (P 0.01 or 0.05), and the improvement of CPT-IP, SC, HVLT-R, DS, CF was more significant in the study group than in the control group at the same time point. There was significant difference between the two groups (P 0.05 or 0.01). The scores of NAB-Mazes and TMT were all improved, but there was no significant difference (p0.05).
(3) Wisconsin Card Classification Test (WCST) before and after treatment was compared between the two groups. The results showed that the study group and the control group completed classification number (Cc), correct response number (Rc) score increased (p 0.01), error response number (Re), persistent response number (Rp), persistent error number (Rpe), non-persistent error number (nRpe) score decreased (p 0.05 or 0.05). Compared with the control group at the same time point, the study group had an advantage (p0.05 or 0.01) in completing the four improvements of classification number, correct response number, error response number and non-persistent error number, while the response number needed to complete the first classification (Rf), conceptual level response percentage (Rf%) could not maintain the complete classification number (F). M), although the two groups of learning and learning (L-L) improved, but there was no statistical significance.
(4) Side effects: In the course of treatment, there were different degrees of adverse reactions in both groups. The number of cases of excitatory agitation in the control group was significantly higher than that in the study group (p0.05), and there was no significant difference in other side effects.
(5) Correlation analysis showed that the positive symptoms, general pathological symptoms and cognitive test results were not correlated. Negative symptoms and language memory, symbol encoding, continuous operation, emotional management, number sequence, total score of MCCB were significantly correlated (p0.01), and persistent response, persistent error were positively correlated (p0.01). Symbol coding, emotional management was negatively correlated (p0.05). PANSS total score and symbol coding, emotional management, language memory, MCCB total score was negatively correlated (p0.01), and persistent response, persistent error was positively correlated (p0.01). Educational level and symbol coding, language memory, emotional management, MCCB total score, persistent response, persistent error were closely related (p0.05). Or 0.01).
(6) Multivariate stepwise regression analysis showed that educational level and negative symptoms were the main influencing factors of cognitive function in schizophrenic patients.
Conclusion: 1. Aripiprazole combined with tamsulosone or aripiprazole alone can effectively improve the mental symptoms of schizophrenic patients.
2. Aripipiprazole combined with tamsulosone can improve the cognitive function of female schizophrenic patients compared with aripiprazole alone.
3. Educational level, negative symptoms and PANSS scores were significantly correlated with cognitive function. Schizophrenic patients with negative symptoms had significant cognitive impairment.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3
【参考文献】
相关期刊论文 前10条
1 曾凡新,傅洁民,董志;非典型抗精神病药的受体药理学研究进展[J];中国临床药理学杂志;2003年05期
2 盛建华;宋振华;施慎逊;袁一萍;;精神分裂症的记忆功能及其影响因素[J];精神医学杂志;2007年03期
3 宋振华;盛建华;施慎逊;虞一萍;;精神分裂症患者的认知功能及其影响因素[J];精神医学杂志;2008年05期
4 缪金生;;坦度螺酮治疗记忆障碍的研究进展[J];四川精神卫生;2008年01期
5 赵靖平;抑郁症药物治疗的一些近代观点[J];四川精神卫生;1999年01期
6 翁史e，
本文编号：2220704
本文链接：https://www.wllwen.com/yixuelunwen/jsb/2220704.html
最近更新
教材专著
