刘颖　朱永

[摘要] 目的 探討阿立哌唑联合帕罗西汀治疗精神分裂症后抑郁的临床疗效。 方法 选择2019年1—12月在我院诊断治疗的精神分裂症后抑郁患者60例为研究对象，随机分为联合组与对照组，每组各30例。两组均给予阿立哌唑口服治疗，联合组在此基础上加用帕罗西汀治疗。比较两组治疗前后HAMD评分、PANSS评分及不良反应发生情况。 结果 治疗后4周及8周，两组HAMD评分均显著低于治疗前;联合组HAMD评分分别为（12.5±2.0）分、（8.4±1.3）分，显著低于对照组的（16.6±1.8）分、（11.5±1.6）分，差异有统计学意义（P<0.05）。治疗后两组PANSS阳性因子评分、阴性因子评分、一般精神病理学分及总分均呈下降趋势;治疗后4周及8周，联合组PANSS阳性因子评分、阴性因子评分、一般精神病理学分及总分均显著低于对照组，差异有统计学意义（P<0.05）。两组各不良反应发生率比较，差异无统计学意义（P>0.05）。 结论 阿立哌唑联合帕罗西汀治疗精神分裂症后抑郁，可以改善患者的HAMD评分、PANSS阳性因子评分、阴性因子评分、一般精神病理学分及总分，并且不显著增加不良反应。

[关键词] 帕罗西汀;阿立哌唑;精神分裂症;抑郁

[中图分类号] R749.3          [文献标识码] B          [文章编号] 1673-9701（2021）06-0123-04

Clinical effect of aripiprazole combined with paroxetine in the treatment of post-schizophrenia depression

LIU Ying   ZHU Yong

1.Inpatient Department Pharmacy， Jiamusi Psychiatric Welfare Hospital in Heilongjiang Province， Jiamusi   154002， China; 2.The Sixth Ward， Jiamusi Psychiatric Welfare Hospital in Heilongjiang Province， Jiamusi  154002， China

[Abstract] Objective To explore the clinical efficacy of aripiprazole combined with paroxetine in the treatment of post-schizophrenia depression. Methods A total of 60 patients with post-schizophrenia depression who were diagnosed and treated in our hospital from January to December 2019 were selected as the research subjects， and they were randomly divided into a combination group and a control group， with 30 cases in each group. Both groups were orally given aripiprazole for treatment. The combination group was further treated with paroxetine on this basis. The HAMD score， PANSS score and adverse reactions were compared between the two groups before and after treatment. Results After treatment for 4 weeks and 8 weeks， the HAMD scores in both groups were decreased significantly compared with those before treatment; after treatment for 4 weeks and 8 weeks， the HAMD score of the combination group were（12.5±2.0） points and （8.4±1.3） points， statistically significantly lower than （16.6±1.8） points and （11.5±1.6） points of the control group （P<0.05）. After treatment， the PANSS positive factor scores， negative factor scores， general psychopathology scores and total scores in both groups all showed a downward trend. After 4 weeks and 8 weeks of treatment， the PANSS positive factor scores， negative factor scores， general psychopathology scores and total scores in the combination group were significantly lower than those in the control group， and the differences were statistically significant （P<0.05）. There was no statistically significant difference in the incidence rate of each adverse reactions between the two groups（P>0.05）. Conclusion Aripiprazole combined with paroxetine in the treatment of post-schizophrenia depression can improve the patients′ HAMD score， PANSS positive factor scores， negative factor scores， general psychopathology scores and total scores， and does not significantly increase the adverse reactions.

[Key words] Paroxetine; Aripiprazole; Schizophrenia; Depression

精神分裂症患者具有思维、感知、情感、行为等多方面的障碍、精神活动不协调及精神活动与环境不协调，青壮年多发，患者通常意识正常、智能正常，患者病情多迁延不愈。精神分裂症后抑郁指精神分裂症残留期或精神病后伴有抑郁症状，发生率为25%，是精神分裂症患者自杀的主要原因之一[1-2]。该病由抗精神病药物所致，原发精神分裂症本身伴抑郁症状，精神症状消失后，患者因曾患精神分裂症而感到悲观消极。帕罗西汀是治疗抑郁症的主要药物，适合治疗伴有焦虑症的抑郁症患者，其作用快、远期疗效较好[3]。阿立哌唑可用于治疗各类型的精神分裂症，对精神分裂症的阳性及阴性症状均有明显的效果，也能改善患者伴发的情感症状，降低精神分裂症的复发率[4]。……