摘要
目的探讨托吡酯联合利培酮治疗精神分裂症的效果及对体重的影响。方法选取2015年9月～2017年3月我院收治的58例住院以及门诊精神分裂症患者作为研究对象,依照双盲法将其分为观察组(28例)与对照组(30例)。对照组患者采用利培酮治疗,观察组在对照组基础上给予托吡酯治疗。比较两组患者的治疗情况、治疗前后体重指数(BMI)情况、阳性与阴性症状量表(PANSS)评分及不良反应发生情况。结果治疗半年,观察组失访4例,对照组失访7例。观察组患者的治疗总有效率为83.33%,高于对照组的78.26%,差异有统计学意义(P<0.05)。观察组患者的药物剂量为(3.78±1.52)mg/d,与对照组的(3.55±1.36)mg/d比较,差异无统计学意义(P>0.05)。两组患者治疗前的BMI比较,差异无统计学意义(P>0.05);两组患者治疗1、2、3、6个月的BMI均高于治疗前,差异有统计学意义(P<0.05);观察组患者治疗3、6个月的BMI均低于对照组,差异有统计学意义(P<0.05);两组患者治疗1、2个月的BMI比较,差异无统计学意义(P>0.05)。两组患者治疗前的PANSS评分比较,差异无统计学意义(P>0.05);两组患者治疗1、2、3、6个月的PANSS评分均低于治疗前,差异有统计学意义(P<0.05);两组患者治疗1、2、3、6个月的PANSS评分比较,差异无统计学意义(P>0.05)。观察组患者的不良反应总发生率为12.50%,与对照组的13.04%比较,差异无统计学意义(P>0.05)。结论对于精神分裂症者,使用托吡酯与利培酮联合治疗,能在取得满意效果的同时,控制体重,降低患者发生心血管不良事件以及糖尿病发生率,改善体脂率,避免复发风险。只要剂量合理得当,就能取得满意成效,安全性强,副作用可耐受,值得进一步推广使用。
Objective To investigate the effect of Topiramate combined with Risperidone in the treatment of schizophrenia and its effect on body weight.Methods A total of 58 hospitalized and outpatient schizophrenia patients admitted to our hospital from September 2015 to March 2017 were selected as subjects.They were divided into the observation group(28 cases)and the control group(30 cases)according to double-blind method.The control group was treated with Risperidone,and the observation group was given Topiramate on the basis of the control group.The treatment status,body mass index(BMI),positive and negative symptom scale(PANSS)scores before and after treatment and adverse reactions were compared between the two groups.Results During the treatment for half a year,4 patients were lost to the follow-up in observation group and 7 patients were lost to follow-up in the control group.The total effective rate of treatment in the observation group was 83.33%,which was higher than that in the control group(78.26%),and the difference was statistically significant(P<0.05).The drug dose of the observation group was(3.78±1.52)mg/d,which was not significantly different from that of the control group accounting for(3.55±1.36)mg/d(P>0.05).There was no significant difference in BMI between the two groups before treatment(P>0.05).The values of BMI in the two groups at 1,2,3,and 6 months of treatment were higher than those before treatment,and the differences were statistically significant(P<0.05).The values of BMI at 3 and 6 months of treatment in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the BMI values at 1 and 2 months of treatment between the two groups(P>0.05).There were no significant differences in PANSS scores between the two groups before treatment(P>0.05).The PANSS scores at 1,2,3,and 6 months of treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).There were no significant differences in PANSS scores at 1,2,3,and 6 months of treatment between the two groups(P>0.05).The total incidence of adverse reactions in the observation group was 12.50%,compared with 13.04%in the control group,and the difference was not statistically significant(P>0.05).Conclusion For patients with schizophrenia,the combination of Topiramate and Risperidone can achieve satisfactory results,control body weight,reduce the incidence of cardiovascular adverse events and diabetes,improve body fat percentage,and avoid the risk of recurrence.As long as the dose is reasonably correct,satisfactory results can be achieved,safety is high,side effects can be tolerated,and it is worthy of further promotion.
作者
孙乃建
SUN Nai-jian(Department of Psychiatry,Mental Health Center in Huanggang City,Hubei Province,Huanggang438000,China)
出处
《中国当代医药》
2018年第34期81-84,共4页
China Modern Medicine
关键词
利培酮
托吡酯
精神分裂症
疗效
体重影响
Risperidone
Topiramate
Schizophrenia
Efficacy
Weight effect
