氯氮平联合利培酮治疗伴攻击行为精神分裂症患者对照探究.docVIP

氯氮平联合利培酮治疗伴攻击行为精神分裂症患者对照探究 　【关键词】 精神分裂症；攻击行为；利培酮；氯氮平；简明精神病量表；攻击行为观察量表 　　【摘要】 目的 探讨氯氮平联合利培酮治疗伴攻击行为精神分裂症患者的临床疗效及安全性。 方法 将72例伴攻击行为的精神分裂症患者随机分为两组各36例，两组均给予氯氮平治疗，研究组在此基础上联合利培酮治疗。疗程均为6 w。于治疗前和治疗1 w、2 w、4 w、6 w末采用简明精神病量表和攻击行为观察量表评定临床疗效。 结果 治疗1 w末起，两组简明精神病量表总分、研究组攻击行为量表评分均较治疗前有极显著下降（Plt;0.01）；治疗2 w末起对照组攻击行为量表评分较治疗前有极显著下降（Plt;0.01）。两组间同期评分比较研究组较对照组下降更显著（Plt;0.05或0.01）；两组不良反应相当（Pgt;0.05），且均较轻微。结论 氯氮平联合利培酮治疗伴攻击行为精神分裂症患者起效快，疗效更显著，不良反应率和程度并不增加，值得临床推广应用。 　　【关键词】 精神分裂症；攻击行为；利培酮；氯氮平；简明精神病量表；攻击行为观察量表 　　A control study on risperdone combined with clozapine in the treatment of schizophrenia with aggressive behavior 　　【Abstract】 Objective To explore the curative effect and safety of risperdone combined with clozapine in the treatment of schizophrenia with aggressive behavior. Methods 72 schizophrenics with aggressive behavior were randomly divided into research group(n=two groups. The patients (n=36) in group A were treated with risperdone combined with clozapine, with the control of group B(n=36) only with clozapine, both for six weeks. The Scales of Brief Psychiatric Rating Scale (BPRS) and Attack Behavior Observation Scale(ABOS) were evaluated before and after 1,2,4,6 weeks of treatment. Results Two groups showed fine efficacy, but group A effected faster one week than group B（Plt;0.01）.Besides, at different time points the BPRS scores and the ABOS scores in group A were lower than those in group B with statistically significant difference（Plt;0.05 or Plt;0.01）.There was no significant difference in side effects between the two groups (Pgt;0.05). Conclusion Risperdone combined with clozapine was more effective than clozapine alone in the treatment of schizophrenia with attack behavior. 　　【Keywords】 Schizophrenia; aggressive behavior; risperdone; clozapine; the BPSR; the ABOS 　　攻击行为是指伤害或试图伤害另一个体的心理、躯体状态或破坏其他目标(如物体)的行为。精神分裂症患者因受精神症状支配，可发生伤人、毁物、抢物、自杀自伤等攻击行为，严重威胁着社会和家庭的正常生活。为此，作者应用氯氮平联合利培酮进行了对照研究，现报告如下。 　　1 对象与方法 　　1.1 对象 选取2005年7月～2006年6月在我院住院的72例伴攻击行为的精神分裂症患者为研究对象。入组标准：（1）符合《中国精神障碍分类与