氯氮平合并无抽搐电休克治疗难治性精神分裂症的对照研究

摘要

Objective To study the efficiency and side effects of clozapine combined with Modified Electroconvulsive Therapy (MECT) for patients with refractory schizophrenia.Methods A total of 60 patients with refractory schizophrenia were randomized into study group (30 cases) treated with clozapine combined with MECT and control group (30 cases) treated with clozapine monotherapy.The course of treatment was 12 weeks.The Positive and Negative Symptom Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) were used to evaluate the efficacy and side effects.Results The effective rate and improve rate were 43.3％ and 76.7％ respectively in study group, 16.7％ and 53.3％ respectively in control group.There were significant differences in effective rate and improve rate between the two groups (P ＜ 0.05 ).The total score and factor scores of PANSS showed significant differences between the two groups from the 4th week (P ＜ 0.05 ).There was no significant difference in side effects between the two groups ( P ＜0.05 ).Conclusion Clozapine combined with MECT has better efficiency than clozapine for refractory schizophrenia.It is a rational strategy for the treatment of refractory schizophrenia due to its quick effect, less side effects and high security.%目的 评价氯氮平合并无抽搐电休克(MECT)治疗难治性精神分裂症的疗效和安全性.方法 将60例难治性精神分裂症患者随机分为研究组和对照组,分别给予氯氮平合并无抽搐电休克、氯氮平治疗,疗程12周,采用阳性与阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)评定疗效和不良反应.结果 研究组显效率为43.3%,有效率为76.7%;对照组显效率16.7%,有效率53.3%,两组显效率和有效率均有显著性差异(P<0.05).PANSS总分及各因子分从治疗4～6周起两组即有显著性差异(P<0.05或P<0.01);两组副反应比较差异无显著性(P>0.05).结论 氯氮平合并无抽搐电休克治疗难治性精神分裂症疗效优于单用氯氮平,且显效快,副作用少,安全性高,是治疗难治性精神分裂症的较好选择.