CAJ | 학술논문

目的：探讨阿立哌唑与氯氮平联合治疗精神分裂症的交互作用，以明确两种药物联合治疗精神分裂症时的合适剂量。方法将2011年10月至2013年5月于重庆市黔江中心医院诊治为精神分裂症的97例患者随机分为4组（低剂量阿立哌唑＋低剂量氯氮平组、低剂量阿立哌唑＋高剂量氯氮平组、高剂量阿立哌唑＋低剂量氯氮平组、高剂量阿立哌唑＋高剂量氯氮平组），观察比较各组间的疗效和不良反应。结果在改善精神分裂症阳、阴性症状方面，高剂量阿立哌唑＋高剂量氯氮平组效果最好，明显优于其余3组，低剂量阿立哌唑＋高剂量氯氮平组与高剂量阿立哌唑＋低剂量氯氮平组疗效适中，低剂量阿立哌唑＋低剂量氯氮平组疗效最差。在不良反应方面，高剂量阿立哌唑＋高剂量氯氮平组患者发生频率最高，其次为低剂量阿立哌唑＋高剂量氯氮平组，发生较少的是高剂量阿立哌唑＋低剂量氯氮平组与低剂量阿立哌唑＋低剂量氯氮平组，两者之间差异无统计学意义（P＞0．05）。结论阿立哌唑与氯氮平的治疗疗效、不良反应发生率均呈剂量依赖性，在采用上述两种药物联合治疗精神分裂症时，剂量的选择应兼顾药物治疗疗效及不良反应。如患者不良反应严重，可适当下调氯氮平剂量，而阿立哌唑剂量也酌情减量；如患者耐受情况好，可适当上调两种药物剂量。
목적：탐토아립고서여록담평연합치료정신분렬증적교호작용，이명학량충약물연합치료정신분렬증시적합괄제량。방법장2011년10월지2013년5월우중경시검강중심의원진치위정신분렬증적97례환자수궤분위4조（저제량아립고서＋저제량록담평조、저제량아립고서＋고제량록담평조、고제량아립고서＋저제량록담평조、고제량아립고서＋고제량록담평조），관찰비교각조간적료효화불량반응。결과재개선정신분렬증양、음성증상방면，고제량아립고서＋고제량록담평조효과최호，명현우우기여3조，저제량아립고서＋고제량록담평조여고제량아립고서＋저제량록담평조료효괄중，저제량아립고서＋저제량록담평조료효최차。재불량반응방면，고제량아립고서＋고제량록담평조환자발생빈솔최고，기차위저제량아립고서＋고제량록담평조，발생교소적시고제량아립고서＋저제량록담평조여저제량아립고서＋저제량록담평조，량자지간차이무통계학의의（P＞0．05）。결론아립고서여록담평적치료료효、불량반응발생솔균정제량의뢰성，재채용상술량충약물연합치료정신분렬증시，제량적선택응겸고약물치료료효급불량반응。여환자불량반응엄중，가괄당하조록담평제량，이아립고서제량야작정감량；여환자내수정황호，가괄당상조량충약물제량。
Objective To discuss the interaction of aripiprazole combined with clozapine in treatment of schizo-phrenia ,in order to make suitable dose of this combination therapy explicit .Methods A total of 97 cases of schizo-phrenia diagnosed in our hospital between Oct .,2011 and May ,2013 were divided into 4 groups(low dose of aripi-prazole combined with low dose of clozapine ,low dose of aripiprazole combined with high dose of clozapine ,high dose of aripiprazole combined with low dose of clozapine ,high dose of aripiprazole combined with high dose of clozapine ) . The results of efficacy and side effects were all recorded and analyzed .Results In treatment efficacy ,high dose of aripiprazole and clozapine was the best ,when compared with other 3 groups(P<0 .05) ,low dose of aripiprazole and clozapine was the worst (P<0 .05) .On the other hand ,the incidence of side effects was highest in group of high dose of aripiprazole and clozapine ,group of high dose of aripiprazole combined with low dose of clozapine and group of low dose of aripiprazole and clozapine were better than others in safety .Conclusion The efficacy and side effects of aripi-prazole and clozapine are dose dependent ,when using these two medicines to treat schizophrenia ,the doses should be suitable to make good efficacy and avoid side effects .If the side effects are obvious ,the dose of clozapine should be de-creased ,however ,the dose of aripiprazole can be decreased extenuatorily ;If the patients can tolerate the treatment ,the doses of these two medicine can be increased .