CAJ | 학술논문

目的：探讨喹硫平联合丙戊酸钠对缓解伴有冲动及攻击行为的首发精神分裂症患者兴奋躁动的疗效及可能存在的药物不良反应。方法：采用随机分组法，将我院84例伴有攻击行为的首发精神分裂症患者分为合并用药组（喹硫平加丙戊酸钠）及单独用药组（喹硫平），比较两组患者在治疗6周内其外显行为量表、阳性症状和阴性症状量表、阳性症状量表、阴性症状量表、副反应量表及不良反应发生率上的差异。结果：84例病例中脱落3例，实际参与研究81例；其中由外显行为量表结果可知，两组患者治疗2周后症状均有所好转（t合并用药组＝6．241，t单独用药组＝4．352，P＜0．01），但在治疗4周两组间疗效出现一定差异，且合并用药组优于单独用药组（t4周＝9．324，t6周＝13．24，P＜0．01）；而阳性症状和阴性症状量表结果同样显示，随着治疗时间的加长，合并用药组的治疗效果要优于单独用药组（ F＝9．543， P＜0．05）；另外，两组不同治疗时间点上阳性症状量表同样存在差异（t4周＝9．295，t6周＝10．342，P＜0．01）；此外，由副反应量表（TESS）及不良反应情况可知，两组患者不良反应发生率差异无统计学意义，且TESS 评分仅在用药2周后出现过差异（ t ＝4．147，P＜0．05）。结论：对伴有攻击行为的首发精神分裂症患者给予喹硫平联合丙戊酸钠相较于单独使用喹硫平，前者疗效显著，且两者的不良反应发生情况相当。
목적：탐토규류평연합병무산납대완해반유충동급공격행위적수발정신분렬증환자흥강조동적료효급가능존재적약물불량반응。방법：채용수궤분조법，장아원84례반유공격행위적수발정신분렬증환자분위합병용약조（규류평가병무산납）급단독용약조（규류평），비교량조환자재치료6주내기외현행위량표、양성증상화음성증상량표、양성증상량표、음성증상량표、부반응량표급불량반응발생솔상적차이。결과：84례병례중탈락3례，실제삼여연구81례；기중유외현행위량표결과가지，량조환자치료2주후증상균유소호전（t합병용약조＝6．241，t단독용약조＝4．352，P＜0．01），단재치료4주량조간료효출현일정차이，차합병용약조우우단독용약조（t4주＝9．324，t6주＝13．24，P＜0．01）；이양성증상화음성증상량표결과동양현시，수착치료시간적가장，합병용약조적치료효과요우우단독용약조（ F＝9．543， P＜0．05）；령외，량조불동치료시간점상양성증상량표동양존재차이（t4주＝9．295，t6주＝10．342，P＜0．01）；차외，유부반응량표（TESS）급불량반응정황가지，량조환자불량반응발생솔차이무통계학의의，차TESS 평분부재용약2주후출현과차이（ t ＝4．147，P＜0．05）。결론：대반유공격행위적수발정신분렬증환자급여규류평연합병무산납상교우단독사용규류평，전자료효현저，차량자적불량반응발생정황상당。
Objective: To discuss the efficacy and adverse effects of quetiapine combined with valproate in alleviating impulsive and aggressive behavior associated with first-episode schizophrenia patients.Methods: A randomized method, 84 cases of aggressive behavior associated with first-episode schizophrenia patients in our hospital were divided into combination therapy group ( quetiapine+VPA ) and monotherapy group ( quetiapine ) , two groups of patients were compared for 6 weeks’treatment by modified overt aggression scale, positive and negative symptom scale, positive symptom scale, negative syndrome scale, treatment emergent symptom scale and the incidences of adverse reactions.Results:84 cases, shedding three cases, 81 cases of actual participation in the study;by the modified overt aggression scales results, the symptoms of two groups of patients were improved after two weeks, treatment(tcombination therapy group =6.241, tmonotherapy group =4.352, P <0.01), but after the four weeks of treatment, there was difference between the two groups, and the effect of combination therapy group was better than that of monotherapy group ( t4 week =9.324, t6 week =13.24, P<0.01); and positive and negative syndrome scale results also showed that with time of treatment lengthening, the effect of combination therapy group was superior to monotherapy group ( F =9.543, P <0.05 ) .On two different treatment time points, the results of scale for assessment of positive symptoms there were also differences ( t4 week =9.295, t6 week =10.342, P <0.01 ) .In addition, by the results of treatment emergent symptom scale( TESS) and adverse reactions seen in both groups of patients, the incidences of adverse reactions had no significant differences, and the TESS scores after two weeks’ treatment had differences( t=4.147, P<0.05 ) .Conclusion: Compared to quetiapine, the effect of quetiapine combined with valproate is significant, and the incidences of adverse events between the two groups have no differences.