谢玲银　张智勇

[摘要] 目的 探讨使用利培酮联合氯氮平两种药物来治疗难治性精神分裂症的临床效果。 方法 选取我院收治的难治性精神分裂症患者100例为研究对象，随机将其分为观察组和对照组，其中观察组50例，采用利培酮联合氯氮平进行治疗，对照组50例则只服用氯氮平进行治疗，观察12周，分别于入组前、治疗6周末、12周末应用简明精神病评定量表（BPRS）评定治疗效果，同时应用副反应量表（TESS）评价不良反应发生情况。 结果 观察组在治疗6周末及12周末的BPRS 评定总分明显低于对照组，差异有统计学意义（P<0.05）。两组TESS总分比较差异无统计学意义（P>0.05）。 结论 临床上对于难治性精神分裂症这一疾病的治疗可采用利培酮联合氯氮平两种药物进行尝试，其临床效果显著，且安全性有较大程度的保障，值得临床推广应用。

[关键词] 利培酮；氯氮平；难治性精神分裂症

[中图分类号] R749.3 [文献标识码] B [文章编号] 2095-0616（2015）15-88-03

[Abstract] Objective To discuss the clinical effect of risperidone combined with clozapine in the use of two kinds of drugs for the treatment of refractory schizophrenia. Methods 100 patients with refractory schizophrenia of our hospital was selected as the research object， randomly divided into observation group and control group，50 cases in each group，the cases in the observation group was treated by risperidone combined with clozapine，while the cases in the control group only received risperidone treatment，observation of 12 weeks，before entering the group，respectively treatment of 6 weeks and 12 weeks，the efficacy of treatment was assessed by the Brief Psychiatric Rating Scale （BPRS）.And using the TESS to evaluate adverse reaction. Results In the observation group，BPRS total score after 6 weeks and 12 weeks were significantly lower than the control group，the difference was statistically significant （P<0.05）. TESS scores is similar between the two groups ， it has no statistical significance （P>0.05）. Conclusion For refractory schizophrenia，we may try to treat them with the combination of risperidone and clozapine，it is safety and effective，worthy of clinical popularization and application.

[Key words] Risperidone；Clozapine；Refractory schizophrenia

据有关部门统计，在所有精神分裂症患者当中大约占到有25%的精神分裂症患者会对抗精神病药物产生较大阻抗，进而发展成为难治性精神分裂症[1]，成为临床治疗该疾病十分棘手的问题。目前，国内外已经将氯氮平作为治疗难治性精神分裂症的首选且十分有效的药物，但其毒副作用却十分明显，多数患者最终因为难以忍受而导致治疗失败。另据文献资料显示，将利培酮这一类的苯丙异恶唑衍生物联合氯氮平治疗难治性精神分裂症具有一定协同作用，能够在保证安全的基础上进一步提高患者的耐受性，有助于提高临床治疗效果[2]。……