【摘要】 目的 为提升难治性精神分裂症患者用药有效性、安全性，本文重点探讨药物基因组学检测在难治性精神分裂症患者中的应用效果。方法 选择2021年11月—2022年9月在衢州市第三医院诊治的难治性精神分裂症男性患者100例纳入研究，依据随机数表法将患者分为对照组(基于医生经验用药)和观察组(基于药物基因检测用药),每组50例。比较2组临床疗效、自知力、生活质量、出院1个月及1年的社会适应状况、复发率、不良反应发生率。结果 治疗1个月后，观察组患者阳性症状、阴性症状、一般精神病理症状评分均低于对照组[(20.11±2.67)分vs.(23.89±3.10)分，(15.02±1.88)分vs.(18.27±2.33)分，(30.35±2.93)分vs.(35.24±3.80)分，均P<0.001];观察组自知力评定量表(SAI)与简明健康状况调查问卷(SF-36)评分均明显高于对照组[(10.27±1.71)分vs.(7.24±1.62)分，(88.06±18.37)分vs.(73.41±16.82)分，均P<0.001]。出院1个月及1年后，观察组个人和社会功能量表(PSP)评分均明显高于对照组[(68.30±6.10)分vs.(59.24±5.68)分，(81.32±7.30)分vs.(75.49±6.29)分，均P<0.001];观察组药物相关不良反应发生率明显低于对照组(P<0.05)。出院1年后，观察组复发率明显低于对照组(P<0.001)。结论 依据药物基因组检测结果指导难治性精神分裂症临床用药优势明显，症状缓解快，可改善患者生活质量、社会适应性，复发率及不良反应率低，值得临床推广应用。更多还原

【Abstract】 Objective This study aims to improve the efficacy and safety of drug use in patients with refractory schizophrenia, this paper focuses on the application of pharmacogenomic testing in refractory schizophrenia. Methods A total of 100 male patients with refractory schizophrenia who were diagnosed and treated in Quzhou Third Hospital from November 2021 to September 2022 were included in this study. The patients were divided into control group(based on doctors’ experience) and observation group(based on pharmacogenetic testing) according to the random number table method, with 50 cases in each group. The clinical efficacy, insight, quality of life, social adaptation at 1 month and 1 year after discharge, recurrence rate and adverse reaction rate between the two groups were compared. Results After 1 month of treatment, all symptom types(positive, negative, and general psychopathological symptom) in the observation group were lower than those in the control group [(20.11±2.67) points vs.(23.89±3.10) points,(15.02±1.88) points vs.(18.27±2.33) points,(30.35±2.93) points vs.(35.24±3.80) points, all P<0.001]; the scores of schedule for assessing insight(SAI) and 36 item short form(SF-36) in the observation group were significantly higher than those in the control group [(10.27±1.71) points vs.(7.24±1.62) points,(88.06±18.37) points vs.(73.41±16.82) points, both P<0.001]. At 1 month and 1 year after discharge, the personal and social functioning scale(PSP)score of the observation group was significantly higher than that of the control group [(68.30±6.10) points vs.(59.24±5.68) points,(81.32±7.30) points vs.(75.49±6.29) points, both P<0.001]. The incidence of drug-related adverse reactions in the observation group was significantly lower than that in the control group(P<0.05). One year after discharge, the recurrence rate in the observation group was significantly lower than that in the control group(P<0.001). Conclusion It has obvious advantages to guide the clinical medication of refractory schizophrenia according to the results of pharmacogenomic testing. Patients not only have high compliance and fast symptom relief, but also can promote the quality of life, social adaptability, reduce the recurrence rate and adverse reaction rate, which is worthy of clinical promotion.更多还原