齐拉西酮与利培酮治疗难治性精神分裂症对照研究

目的评价齐拉西酮与利培酮治疗难治性精神分裂症的临床疗效及安全性。方法将60例难治性精神分裂症患者随机分为两组各30例,研究组口服齐拉西酮治疗,对照组口服利培酮治疗,观察12w。于治疗前及治疗第4w、8w、12w末采用阳性与阴性症状评定量表评定临床疗效、副反应量表评定不良反应。结果治疗第4w末起两组阳性与阴性症状评定量表总分及各因子分均较治疗前有显著下降（P〈0．01）,并随着治疗的延续呈持续性下降,但治疗12w末研究组阴性症状因子分较对照组下降更显著（P〈0．05）。研究组不良反应发生率为53．3％,对照组为66．7％;研究组治疗8w、12w末副反应量表评分显著低于对照组（P〈0．05）。结论齐拉西酮与利培酮治疗难治性精神分裂症效果均较好,但齐拉西酮适用于耐受差的患者。     

利培酮与奋乃静治疗青少年精神分裂症对照研究

目的探讨利培酮治疗青少年精神分裂症的临床疗效及安全性。方法将65例青少年精神分裂症患者随机分为两组,研究组34例,口服利培酮治疗,对照组31例,口服奋乃静治疗。观察8w。于治疗前及治疗8w末采用阳性与阴性症状量表评定临床疗效、副反应量表评定不良反应。结果治疗8w末,研究组显效率82．3％,对照组为80．6％,两组显效率比较无显著性差异（P〉0．05）;两组治疗8w末阳性与阴性症状量表总分及各因子分均较治疗前下降明显（P均〈0．01）,同期两组间比较均无显著性差异（P均〉0．05）;研究组肌肉震颤、静坐不能、口干、心动过速等不良反应发生率均显著低于对照组（P〈0．05）。结论利培酮治疗青少年精神分裂症疗效显著,不良反应轻,安全性高,依从性好。     

无抽搐电休克治疗精神分裂症激越行为对照研究

目的评价无抽搐电休克治疗精神分裂症患者激越、攻击、破坏行为的临床效果及安全性。方法将60例具有激越、攻击、破坏行为的精神分裂症患者随机分为两组,每组30例,研究组常规进行无抽搐电休克治疗,对照组肌肉注射氟哌啶醇治疗,观察14d。于治疗前及治疗1d、3d、7d、9d、14d末采用阳性与阴性症状量表、临床总体印象量表、副反应量表评定临床疗效及不良反应。结果治疗后两组阳性与阴性症状量表总分、阳性症状分、兴奋症状分、临床大体印象量表总分均较治疗前有显著下降（P〈0．05或0．01）;同期研究组均较对照组下降显著（P〈0．05或0．01）,副反应量表评分显著低于对照组（P〈0．05）。结论无抽搐电休克治疗精神分裂症激越行为起效快、疗效显著、不良反应轻微、安全性高。     

心理治疗在精神分裂症临床治疗中的应用效果

目的分析心理治疗在精神分裂症临床治疗中的应用效果。方法将本院精神科2015年8月至2017年8月收治的90例精神分裂症患者利用随机分组法分为参照组(n=45)和观察组(n=45)。参照组行喹硫平治疗,观察组在参照组基础上加行心理治疗。比较两组治疗效果。结果治疗后,两组阳性症状、阴性症状、一般精神症状评分及PANSS总分、焦虑、抑郁评分均降低,且观察组低于参照组(P<0.05)。观察组患者的治疗依从率高于参照组(P<0.05)。结论给予精神分裂症患者心理治疗,可有效改善患者的心理状况。     

丙戊酸钠联合帕利哌酮治疗精神分裂症的疗效观察

目的研究丙戊酸钠联合帕利哌酮治疗精神分裂症的临床疗效。方法选择2014年4月—2016年1月到北京市昌平区中西医结合医院诊治的精神分裂症患者104例,随机分为对照组和治疗组,每组各52例。对照组口服帕利哌酮缓释片,起始剂量为6 mg/d,1周内根据病情将剂量调整为6~9 mg/d。治疗组在对照组治疗基础上口服丙戊酸钠缓释片,起始剂量为0.5 g/d,最大剂量为1.5~2.0 g/d,可根据病情酌情加减。两组患者均持续治疗12周。观察两组的临床疗效,同时比较两组治疗前后阴性和阳性症状量表(PANSS)评分和个人和社会功能量表(PSP)评分的变化情况。结果治疗后,对照组和治疗组的总有效率分别为80.77%、94.23%,两组比较差异有统计学意义(P0.05)治疗后6、12周,两组阳性症状评分、阴性症状评分、精神病理评分、PANSS总分显著下降,PSP评分显著升高,同组治疗前后差异有统计学意义(P0.05),且治疗组这些评分的改善程度优于对照组,两组比较差异具有统计学意义(P0.05)。结论丙戊酸钠联合帕利哌酮治疗精神分裂症疗效显著,有效缓解临床症状,改善社会功能,安全性好,具有一定的临床推广应用价值。     

Evaluation of neurotransmitter receptor gene expression identifies GABA receptor changes: A follow-up study in antipsychotic-naïve patients with first-episode psychosis

A study of the gene expression levels in the blood of individuals with schizophrenia in the beginning of the disease, such as first-episode psychosis (FEP), is useful to detect gene expression changes in this disorder in response to treatment. Although a large number of genetic studies on schizophrenia have been conducted, little is known about the effects of antipsychotic treatment on gene expression. The aim of the present study was to examine differences in the gene expression in the blood of antipsychotic-naïve FEP patients before and after risperidone treatment (N = 44) and also to verify the correlation with treatment response. In addition, we determined the correlations between differentially expressed genes and clinical variables. The expression of 40 neurotransmitter and neurodevelopment-associated genes was assessed using the RT² Profiler™ PCR Array. The results indicated that the GABRR2 gene was downregulated after risperidone treatment, but no genes were associated with response to treatment and clinical variables after Bonferroni correction. GABRR2 downregulation after treatment can both suggest an effect of risperidone treatment or processes related to disease progression, either not necessarily associated with the improvement of symptoms. Despite this change was observed in blood, this decrease in GABRR2 mRNA levels might be an effect of changes in GABA concentrations or other systems interplay consequently to D2 blockage induced by risperidone, for example. Thus, it is important to consider that antipsychotics or the progression of psychotic disorders might interfere with gene expression.     

氟哌啶醇联合齐拉西酮注射液治疗精神分裂症激越症状对照研究

目的：探讨氟哌啶醇联合齐拉西酮注射液治疗精神分裂症患者急性激越症状的疗效和安全性。方法将94例伴急性激越症状的精神分裂症患者按入组顺序随机分为两组,均肌内注射氟哌啶醇注射液治疗,联合组联合肌内注射齐拉西酮注射液治疗,观察72 h。于治疗前后采用阳性与阴性症状量表及临床疗效总评量表病情严重程度分量表评定病情严重程度,阳性与阴性症状量表兴奋因子分评定兴奋激越症状改善状况,副反应量表评定不良反应。结果治疗72 h 后两组阳性与阴性症状量表及临床疗效总评量表病情严重程度分量表评分均较治疗前显著下降(P <0.01),联合组较对照组下降更显著(P <0.05);治疗2 h 起联合组阳性与阴性症状量表兴奋因子评分较治疗前显著下降(P <0.05),治疗6 h 起两组兴奋因子分均较治疗前呈持续性下降(P <0.01),但治疗72 h 两组兴奋激越症状改善有效率比较差异无显著性(P >0.05)。治疗期间两组不良反应均较为轻微,联合组不良反应发生率显著低于对照组(χ2=4.61,P<0.05)。结论氟哌啶醇联合甲磺酸齐拉西酮注射液治疗精神分裂症患者伴急性激越症状较单用氟哌啶醇起效更快,疗效更显著,安全性更高,更有利于患者的后续治疗。     

利培酮氯氮平氯丙嗪治疗首发精神分裂症临床研究

目的探讨氯丙嗪、氯氮平及利培酮治疗精神分裂症的疗效及安全性。方法将资料完整的86例精神分裂症患者随机分为氯丙嗪、氯氮平和利醅酮(甲、乙、丙)治疗组。其中甲组22例,乙组31例,丙组33例。三组疗程均为12w。氯丙嗪、氯氮平剂量25-600mg·d-1,利培酮1-7mg·d-1。采用潘氏量表及药物副反应量表于治疗前及治疗第4、8、12w末评定临床疗效及不良反应。结果治疗第4、8、12w末三组潘氏量表总分,阳性、阴性症状分及一般病理分均下降;乙组、丙组阳性和阴性症状总分减分率较甲组明显高(P<0．01),乙组与丙组差异无显著性。甲组有效率54．6％,乙组67．7％,丙组69．7％。不良反应利培酮少于氯丙嗪、氯氮平,且未发现白细胞减少及直立性低血压。结论利培酮治疗精神分裂症阴性、阳性症状疗效显著,不良反应少。     

齐拉西酮治疗脑血管病所致精神障碍对照研究

目的 探讨齐拉西酮治疗脑血管病所致精神障碍的临床疗效和安全性.方法 将30例脑血管病所致精神障碍患者随机分为A组与B组,每组15例,A组口服齐拉西酮治疗,B组口服利培酮治疗,观察8周.于治疗前及治疗2周、4周、6周、8周末,采用阳性与阴性症状量表、临床疗效总评量表及副反应量表评定疗效和不良反应.结果 治疗后两组阳性与阴性症状量表总分和各因子分及临床疗效总评量表评分均较治疗前呈持续性下降(P＜0.01),同期两组间评分比较差异均无显著性(P＞0.05).两组不良反应均轻微,发生率差异无显著性(P＞0.05),但治疗8周末A组副反应量表总分显著低于B组(P＜0.05).结论 齐拉西酮治疗脑血管病所致精神障碍疗效显著,安全性高,依从性好.     

Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia

ObjectiveStudies of the effects of the N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, ketamine, have suggested similarities to the symptoms of schizophrenia. Our primary goal was to evaluate the dimensions of the Positive and Negative Syndrome Scale (PANSS) in ketamine users (acute and chronic) compared to schizophrenia patients (early and chronic stages).MethodWe conducted exploratory factor analysis for the PANSS from four groups: 135 healthy subject administrated ketamine or saline, 187 inpatients of ketamine abuse; 154 inpatients of early course schizophrenia and 522 inpatients of chronic schizophrenia. Principal component factor analyses were conducted to identify the factor structure of the PANSS.ResultsFactor analysis yielded five factors for each group: positive, negative, cognitive, depressed, excitement or dissociation symptoms. The symptom dimensions in two schizophrenia groups were consistent with the established five-factor model (Wallwork et al., 2012). The factor structures across four groups were similar, with 19 of 30 symptoms loading on the same factor in at least 3 of 4 groups. The factors in the chronic ketamine group were more similar to the factors in the two schizophrenia groups rather than to the factors in the acute ketamine group. Symptom severities were significantly different across the groups (Kruskal–Wallis χ²(4) = 540.6, p < 0.0001). Symptoms in the two ketamine groups were milder than in the two schizophrenia groups (Cohen's d = 0.7).ConclusionOur results provide the evidence of similarity in symptom dimensions between ketamine psychosis and schizophrenia psychosis. The interpretations should be cautious because of potential confounding factors.