發(fā)布時(shí)間：2018-08-06 14:25

【摘要】：目的：調(diào)查不同年代和不同地區(qū)住院精神分裂癥患者的藥物治療情況，包括治療方案、抗精神病藥物種類和劑量，聯(lián)合用藥和合并用藥情況，了解近30年以來抗精神藥物使用變遷，為臨床合理用藥提供依據(jù)。 方法：采用回顧性研究設(shè)計(jì)，從三家不同地區(qū)的精神�？漆t(yī)院病案室中分別抽取1980s、、1990s、2000s首次入院的精神分裂癥患者的病歷各50份，并采用自制調(diào)查表調(diào)查診斷及用藥情況。使用SPSSl6.0統(tǒng)計(jì)軟件對結(jié)果進(jìn)行統(tǒng)計(jì)描述和統(tǒng)計(jì)分析。統(tǒng)計(jì)分析方法：卡方檢驗(yàn)、描述性統(tǒng)計(jì)分析、方差分析，P＜0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1.不同年代之間聯(lián)合用藥組之間（第一代抗精神病藥（FGA）+FGA組，第二代抗精神病藥（SGA）+FGA組，SGA+SGA組）比較差異顯著性明顯（χ2=125.8，P=0.000），不同年代之間抗膽堿能藥比較（χ2=16.829，P=0.000），抗焦慮藥比較（χ2=9.678，P=0.008），抗驚厥藥比較（χ2=6.315，P=0.043）。把合并其他藥物種類分成兩組（大于等于2種，小于2種）比較發(fā)現(xiàn)差異性顯著（χ2=8.235，P=0.016）。三個(gè)年代之間穩(wěn)定后治療劑量之間比較差異性不顯著，而時(shí)點(diǎn)最高劑量在男女患者群體中均有逐年下降的趨勢（p男=0.002，p女=0.041），關(guān)于不同年代男女之間穩(wěn)定后治療劑量的比較發(fā)現(xiàn)，2000s男女之間穩(wěn)定后治療劑量差異性顯著，且男性高于女性（p=0.010）。 2.對三個(gè)地區(qū)之間聯(lián)合使用抗精神病藥物的比較發(fā)現(xiàn)：單一用藥組與聯(lián)合用藥組（χ2=13.430，P=0.0010.05），聯(lián)合用藥方式（FGA+FGA組，SGA+FGA組，SGA+SGA組）比較（χ2=26.363，P=0.0000.05），有無合并其他用藥組比較（χ2=40.200，P=0.0000.05），有無合并抗膽堿能藥組比較（χ2=15.332，P=0.0000.05），有無合并抗焦慮藥組比較（χ2=44.261，P=0.0000.05），有無合并抗驚厥藥組差異顯著性不明顯（χ2=5.896，P=0.052），把合并其他藥物種類分成兩組（大于等于2種，小于2種）比較發(fā)現(xiàn)差異性顯著（χ2=41.727，P=0.0000.05）。三個(gè)地區(qū)之間穩(wěn)定后治療劑量的比較差異性不顯著，而C地區(qū)時(shí)點(diǎn)最高劑量高于A地區(qū)和B地區(qū)，差異顯著性明顯（p=0.0300.05），另外，男女性別之間用藥劑量比較發(fā)現(xiàn)，C地區(qū)男女時(shí)點(diǎn)最高劑量的比較差異性顯著（p=0.000，男女），A地區(qū)和C地區(qū)男女穩(wěn)定后治療劑量的比較差異性顯著（p=0.012，p=0.011，且均男女）。 結(jié)論：1.三個(gè)年代之間聯(lián)合用藥和合并用藥方式都發(fā)生了顯著改變，非典型抗精神病藥物使用頻率和合并使用抗焦慮和抗驚厥藥物頻率呈遞增趨勢，，最高用藥劑量呈下降趨勢。2.三個(gè)地區(qū)之間的比較發(fā)現(xiàn)，C地區(qū)使用第二代抗精神病藥物的比例最高，B地區(qū)次之，A地區(qū)最少；在合并其他用藥方式中，C地區(qū)合并抗膽堿能藥以及抗焦慮藥的頻率高于B地區(qū)和A地區(qū)；C地區(qū)合并兩種或兩種以上用藥的現(xiàn)象比A地區(qū)和B地區(qū)更普遍；
[Abstract]:Objective: to investigate the drug treatment of inpatients with schizophrenia in different ages and regions, including treatment regimen, types and doses of antipsychotic drugs, combined and combined use. To understand the changes in the use of antipsychotic drugs in recent 30 years and to provide evidence for rational use of drugs in clinic. Methods: a retrospective study design was used to collect 50 medical records of schizophrenic patients who were first admitted to hospital in 1980 s or 1990 s / 2000s from the medical record rooms of three different regions of psychiatric hospitals, and to investigate the diagnosis and medication of schizophrenia by self-made questionnaire. SPSSl6.0 statistical software is used to describe and analyze the results. Statistical analysis methods: chi-square test, descriptive statistical analysis, ANOVA (P < 0.05) were statistically significant. The result is 1: 1. Between the different age groups (FGA) FGA group, first generation antipsychotic drug), There were significant differences between the second generation antipsychotics (SGA) FGA group and the control group (蠂 2 + 125.8% P0. 000), the comparison of anticholinergic drugs (蠂 2 + 16. 829 P0. 000), the comparison of anti anxiety drugs (蠂 2 + 9. 678% P0. 008), and the comparison of anti convulsion drugs (蠂 2 + 6. 315 P0. 043). There were significant differences between the two groups (> 2, less than 2) (蠂 2 + 8. 235%, P < 0. 016). There was no significant difference between the stable post-treatment doses in the three decades. However, the highest dose at the time point decreased year by year in both male and female patients (p male 0.002p female 0.041). The comparison of stable post-treatment dose between male and female in different ages showed that there was a significant difference in stable post-treatment dose between male and female in 2000s. And the male was higher than the female (p0.010). The comparison of antipsychotic drugs used in three regions was found: single drug group and combination drug group (蠂 2 + 13.430), (FGA FGA group (P < 0. 0010.05) and (FGA FGA group (P < 0. 0000. 05), there were no other drugs (蠂 2 40.200), and there was no significant difference between the two groups (蠂 2, P < 0. 05, P < 0. 000), and the (FGA FGA group (P < 0. 0005). The comparison of anti-cholinergic drug group (蠂 ~ 2 + 15.332P ~ (0.0000.05), the group with or without an anti-anxiety drug (蠂 ~ (2 +) ~ (44.261) (蠂 ~ (0.0000.05), and the group with or without anticonvulsant drugs were not significant (蠂 ~ (2) ~ (5.896) P ~ (0.052), and the other drugs were divided into two groups (> 2), and no significant difference was found between the two groups (> 2). There were significant differences between the two species (蠂 2: 41.727 P 0.0000.05). There was no significant difference in the treatment dose between the three regions after stabilization, but the highest dose at time point in C area was higher than that in A area and B area, and the difference was significant (p0. 0300.05). The results showed that there was a significant difference between male and female in the highest dose at the time point between male and female (p0. 000, male and female). There was significant difference between male and female in stable treatment dose in area A and C (p0. 012, p0. 011, and both male and female). Conclusion 1. During the three decades, the combination and combination of drugs changed significantly, the frequency of atypical antipsychotic drugs and the frequency of combined use of anti-anxiety and anticonvulsant drugs showed an increasing trend, and the highest dosage of antipsychotics showed a downward trend of 0.2. The comparison among the three regions showed that the second generation of antipsychotic drugs was the highest in area C and the lowest in area B, followed by area A. The frequency of combination of anticholinergic drugs and antianxiety drugs in area C was higher than that in area B and area A in combination with two or more kinds of drugs.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.3

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