胡　垒，王立广(1.厦门市仙岳医院神经内科，福建 厦门　36101； .厦门市仙岳医院门诊，福建 厦门　36101)



丙戊酸钠及氯硝西泮治疗迟发性运动障碍的疗效观察

胡垒1*，王立广2(1.厦门市仙岳医院神经内科，福建 厦门361012； 2.厦门市仙岳医院门诊，福建 厦门361012)

DOI10.14009/j.issn.1672-2124.2016.02.006

摘要目的：探讨丙戊酸钠及氯硝西泮治疗迟发性运动障碍(tardive dyskinesia，TD)的疗效和不良反应。方法：将123例迟发性运动障碍患者按随机数字表法分为观察组和对照组，观察组患者给予丙戊酸钠和氯硝西泮，对照组患者给予安慰剂维生素B6。通过异常不自主运动量表(AIMS)评分对患者治疗前，治疗第2、4、8周末的效果进行评定，观察患者的疗效及不良反应。结果：观察组患者应用丙戊酸钠和氯硝西泮治疗后，第2、4、8周末AIMS评分较治疗前明显下降，且明显优于对照组，差异均有统计学意义(P<0.05)；观察组患者TD部位的有效率均达到90.00%以上，而对照组患者有效率均低于10.00%，差异均有统计学意义(P<0.05)；2组患者均未见明显不良反应。结论：丙戊酸钠及氯硝西泮治疗TD安全有效，值得临床推广。

关键词迟发性运动障碍； 丙戊酸钠； 氯硝西泮

Observation on Efficacy of Sodium Valproate and Clonazepam in Treatment of Tardive Dyskinesia

HU Lei1,WANG Liguang2(1.Dept.of Neurology, Xiamen Xianyue Hospital, Fujian Xiamen 361012, China； 2.Dept.of Outpatient, Xiamen Xianyue Hospital, Fujian Xiamen 361012, China)

ABSTRACTOBJECTIVE：To probe into the efficacy and adverse reactions of sodium valproate and clonazepam in treatment of tardive dyskinesia(TD). METHODS: 123 cases with TD were divided into observation group and control group via the random number table. The observation group were treated with sodium valproate and clonazepam, the control group received placebo vitamin B6. The effects of before and after 2, 4, 8 weeks were determined via abnormal involuntary movement scale (AIMS). The efficacy and adverse reactions in patients were observed. RESULTS: After treatment with sodium valproate and clonazepam, scores of AIMS after 2, 4, 8 weeks were significantly decreased than before in observation group, which was better than the control group, with statistically significant difference (P<0.05). The effective rate of TD was 90.00% in observation group, while in control group, it was lower than 10.00%, with statistically significant difference (P<0.05). There was no obvious adverse reactions between two group pf patients. CONCLUSIONS: Sodium valproate and clonazepam in treatment of TD is safe and effective, it is worthy of clinical promotion.

KEYWORDSTD; Sodium valproate; Clonazepam

迟发性运动障碍(tardive dyskinesia，TD)是一种特殊而持久的锥体外系反应，主要表现为口、唇、舌等部位的不自主活动以及四肢、躯干的舞蹈样动作和肌张力障碍[1]。TD的发生率高,治疗困难，常常影响患者的日常生活和服药依从性。本研究选用丙戊酸钠及氯硝西泮治疗TD患者，观察患者的临床疗效和不良反应，现报告如下。

1资料与方法

1.1资料来源

选择厦门市仙岳医院神经内科2012年3月—2015年3月收治的123例TD患者作为研究对象。纳入标准：年龄18～65岁，符合《中国精神障碍分类与诊断标准》(3版)中关于精神分裂症诊断标准，病程≥2年，服用抗精神病药时间≥3个月，符合Schooler和Kane制定的研究用持续性TD诊断标准[2]。……