【摘要】 目的:探讨奥氮平联合牛黄宁宫片治疗难治性精神分裂症的临床疗效及安全性。方法:选取新乡医学院第二附属医院2009年8月-2012年6月收治的112例难治性精神分裂症患者,将其随机分为对照组和观察组,每组56例。对照组口服奥氮平治疗,起始剂量5 mg·d-1,1周内治疗剂量增至10 mg。观察组在对照组治疗基础上口服牛黄宁宫片,5片/次,1日3次。8周后,观察并比较两组患者的阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)、不良反应症状量表(TESS)以及复发率。结果:对照组和观察组的总有效率分别为62.50%,75.00%,观察组和对照组间的总有效率比较有显著性差异。治疗8周后,对照组肝郁化火、痰火内扰及阴虚火旺的中医证候辨证疗效评分分别为(2.51±0.27),(2.68±0.32),(2.47±0.39)分;观察组的为(1.35±0.21),(1.28±0.13),(1.87±0.42)分,治疗后两组的中医证候辨证疗效评分比较差异具有统计学意义(P<0.05或P<0.01)。从治疗第4周末起的各时点,观察组的PANSS总分、阳性症状分、阴性症状分、精神病理分及CGI-SI总分均较对照组明显下降(P<0.05或P<0.01)。对照组的TESS值为(0.72±0.23),观察组为(0.54±0.16);观察组1年内复发率21.43%;对照组在1年内复发率32.43%。观察组的不良反应及复发率明显低于对照组(P<0.05或P<0.01)。结论:奥氮平联合牛黄宁宫片治疗难治性精神分裂症的临床疗效显著,不良反应少,复发率低,值得在临床广泛推广。更多还原

【Abstract】 Objective: To explore the curative effects and safety of olanzapine combined with Niuhuang Ningong tablet in treatment-resistant schizophrenia.Method: One hundred and twelve patients of treatmentresistant schizophrenia were randomly divided into observation and control groups.Olanzapine was taken oral in control group(n = 56) for 8 weeks,the starting dose was 5 mg·d-1,and added to 10 mg·d-1in weeks.56patients of observation group took olanzapine combined with Niuhuang Ningong tablet for 8 weeks,the dose of Niuhuang Ningong tablet were 5 piece / times,tid.Clinical effectiveness and side effects were assessed with positive and negative symptom scale(PANSS),global assessment scale(GAS) and treatment emergent symptom scale(TESS) before treatment and at the end of 8 weeks of treatment.Result: The total effective rate of control group was 62.50%,and the and the total effective rate of observation group was 75.00%.the treatment TCM of pathogenic fire derived from stagnation of liver-QI,innter disturbance by phlegmatic fire(IDPF) and exuberant fire due to yin-depletion(EFYD) in control group were(2.51 ± 0.27),(2.68 ± 0.32),(2.47 ± 0.39); the treatment TCM of pathogenic fire derived from stagnation of liver-QI,innter disturbance by phlegmatic fire(IDPF)and exuberant fire due to yin-depletion(EFYD) in observation group were(1.35 ± 0.21),(1.28 ± 0.13),(1.87 ± 0.42).There were more significant difference in the total effective rate and after treatment Chinese Medicine symptom between observation group and the control group(P < 0.05 or P < 0.01).Compare with the control group,PANSS score,positive symptoms points,negative symptoms points,psychopathological points and CGI-SI total score of the observation group were significantly decreased from the fourth treatment(P < 0.05 or P <0.01).The scores of TESS and the recurrence rate of the control group were(0.72 ± 0.23) and 32.43%,and the scores of TESS and the recurrence rate of the observation group were(0.54 ± 0.16) and 21.43%.So the adverse reaction and the recurrence rate of the observation group were significantly lower than the control group(P <0.05 or P <0.01).Conclusion: The results suggest olanzapine together with Niuhuang Ninggong tablet has good efficacy,less side effects and less recurrence rate in the treatment of treatment-resistant schizophrenia.This method deserves extensive application in the clinical.更多还原