曾惠英+宋丹杏+伍中坚

[摘要]目的 探讨氯氮平联合氨磺必利治疗难治性精神分裂症的临床效果及安全性。 方法 选取我院2015年6月～2016年6月收治的80例精神分裂癥患者，依照随机数字表法分为对照组和观察组，各40例。对照组给予氯氮平治疗，观察组给予氯氮平联合氨磺必利治疗。采用阳性与阴性症状量表（PANSS）及副反应量表（TESS）在治疗12周后评定两组的临床疗效和药品不良反应。结果 观察组治疗后的总有效率为80.0%，显著高于对照组的62.5%，差异有统计学意义（P<0.05）。观察组治疗后的PANSS总分、阴性及阳性症状评分显著低于对照组治疗后，差异有统计学意义（P<0.05）。两组治疗期间的不良反应比较，差异无统计学意义（P>0.05）。结论 氯氮平联合氨磺必利治疗难治性精神分裂症的临床效果显著，不良反应较少，安全性高。

[关键词]氯氮平；氨磺必利；难治性精神分裂症

[中图分类号] R749.3 [文献标识码] A [文章编号] 1674-4721（2017）05（b）-0112-03

Efficacy and safety analysis of Clozapine combined with Amisulpride in the treatment of refractory schizophrenia

ZENG Hui-ying SONG Dan-xing WU Zhong-jian

Department of Psychiatry，Chronic Disease Prevention and Control Station of Taishan City in Guangdong Province，Taishan 529200，China

[Abstract]Objective To explore the efficacy and safety of Clozapine combined with Amisulpride in the treatment of refractory schizophrenia.Methods 80 patients with refractory schizophrenia admitted in our hospital from June 2015 to June 2016 were selected and divided into the control group and the observation group according to the random number table method，40 cases in each group.The control group was treated with Clozapine，the observation group was treated with Clozapine combined with Amisulpride.The PANSS and TESS were used to evaluate the clinical efficacy and adverse drug reactions of the two groups after 12 weeks of the treatment.Results The total effective rate after treatment of the observation group was 80.0%，which was significantly higher than that of the control group （62.5%），with significant difference （P<0.05）.The total score of PANSS，the negative and positive symptom scores after treatment in the observation group was significantly lower than that in the control group，with significant difference （P<0.05）.There was no significant difference in the incidence rate of adverse reactions between the two groups （P>0.05）.Conclusion The curative effect of Clozapine combined with Amisulpride in the treatment of refractory schizophrenia is significant，it is safe with less adverse reaction.

[Key words]Clozapine；Amisulpride；Refractory schizophrenia

难治性精神分裂症是临床上常见的精神疾病，一直是精神科的难点问题[1-2]。氯氮平是临床上公认的治疗难治性精神分裂症的有效药物，其是一类5-羟色胺（5-hydroxytryptamine，5-HT）拮抗药物，具有椎体反应轻、疗效迅速和较强的抗精神病作用等特点[3-4]。氨磺必利能与大脑多巴胺D2和D3受体亚型选择性结合，是一类苯甲酰胺衍生物，目前氨磺必利逐渐成为治疗精神分裂症的首选药物[5-6]。临床研究显示，氯氮平联合氨磺必利治疗难治性精神分裂症有助于增加氨磺必利的血药浓度，提升治疗效果[7-8]。本研究采用氯氮平联合氨磺必利治疗难治性精神分裂症，探讨其临床疗效和安全性，现报道如下。

1资料与方法

1.1一般资料

选取我院2015年6月～2016年6月收治的80例精神分裂症患者，所有患者符合第3版《中国精神疾病分类诊断标准》（CCMD-3）[9]中关于难治性精神分裂症的诊断标准。……