奥卡西平治疗精神分裂症兴奋激越患者的临床效果及对血清同型半胱氨酸水平的影响

目的探析奥卡西平治疗精神分裂症兴奋激越患者的临床疗效,并分析对患者血清同型半胱氨酸(Hcy)水平的影响。方法前瞻性选取2018年1月至2019年1月海南省安宁医院收治的48例精神分裂症兴奋激越患者为研究对象,采用随机数字表法分为2组,其中对照组(n=24)予以氟哌啶醇治疗,治疗组(n=24)予以奥卡西平治疗。比较2组患者治疗前、治疗2个月以及3个月后的阳性和阴性症状量表兴奋因子(PANSS-EC)减分值评分变化,并同时比较临床治疗总有效率,观察血清治疗前、治疗3个月后的血清Hcy水平,记录不良反应发生情况。结果治疗前与治疗2个月后,2组患者的PANSS-EC减分值组间比较(1.68±0.83)分vs.(1.43±0.57)分、(5.48±3.10)分vs.(5.12±3.03)分],差异无统计学意义(P>0.05);治疗3个月后,治疗组的PANSS-EC减分值显著高于对照组(13.03±4.23)分vs.(8.38±4.15)分],差异有统计学意义(P<0.05)。治疗组临床总有效率(83.33%)明显高于对照组(50.00%),差异有统计学意义(P<0.05)。治疗前,2组患者的血清Hcy水平比较(26.68±4.83)μmol/L vs.(27.24±4.57)μmol/L],差异无统计学意义(P>0.05);治疗3个月后,治疗组患者的Hcy水平显著低于对照组(7.03±1.23)μmol/L vs.(13.38±2.15)μmol/L],差异有统计学意义(P<0.05)。治疗组总不良反应发病率(4.17%)明显低于对照组(25.00%),差异有统计学意义(P<0.05)。结论相对氟哌啶醇,奥卡西平在治疗精神分裂症兴奋激越患者方面具有优势,临床疗效较高,能有效调节血清Hcy水平,不良反应相对少,安全性较高,值得临床推广应用。

Clinical effect of oxacepine in the treatment of hyperexcitability in patients with schizophrenia and its influence on serum homocysteine level.

Objective To explore the clinical efficacy of oxacepine in the treatment of hyperexcitability in patients with schizophrenia,and to analyze the influence of the patient's indicator serum homocysteine(Hcy),so as to provide a research basis for clinical drug selection and related scientific research.Methods From January 2018 to January 2019,48 patients with schizophrenia and agitation admitted to Anning Hospital of Hainan Province were prospectively selected as the research objects.They were divided into two groups by random number table method,of which the control group(n=24)was treated with haloperidol,and the treatment group(n=24)was treated with oxcarbazepine.Before treatment,2 months after treatment,and 3 months after treatment,the changes in reduction score of the excitatory factor the positive and negative symptom scale(PANSS-EC)were compared.At the same time,the total effective rate of clinical treatment,serum Hcy levels before and 3 months after treatment and the occurrence of adverse reactions were compared.Results Before treatment and after 2 months of treatment,there was no significant difference in reduction score of PANSS-EC between the two groups of patients(1.68±0.83)points vs.(1.43±0.57)points,(5.48±3.10)points vs.(5.12±3.03)points](P>0.05);After 3 months of treatment,reduction score of PANSS-EC of the treatment group were significantly higher than those of the control group(13.03±4.23)points vs.(8.38±4.15)points],the differences were statistically significant(P<0.05).The total clinical effective rate of the treatment group(83.33%)was significantly higher than that of the control group(50.00%),and the difference was significant(P<0.05).Before treatment,there was no significant difference in serum Hcy levels between the two groups(26.68±4.83)μmol/L vs.(27.24±4.57)μmol/L](P>0.05);after 3 months of treatment,the Hcy level of the treatment group was significantly lower than that of the control group(7.03±1.23)μmol/L vs.(13.38±2.15)μmol/L],the difference was statistically significant(P<0.05).The total adverse reaction rate of the treatment group(4.17%)was significantly lower than that of the control group(25.00%),the difference was significant(P<0.05).Conclusion Compared with haloperidol,oxcarbazepine has advantages in the treatment of schizophrenia patients with excitement and agitation.It can effectively regulate serum hcy levels,has high clinical efficacy,relatively few adverse reactions,and high safety.It is worthy of clinical application.