【摘要】：目的：探討阿立哌唑與坦度螺酮聯(lián)用對女性精神分裂癥患者認知功能的影響。 方法：采用隨機對照研究,將100例女性精神分裂癥患者隨機分成兩組,研究組(阿立哌唑聯(lián)用坦度螺酮),對照組(阿立哌唑),阿立哌唑起始劑量15mg/d,兩周后加至治療劑量20mg/d,最大劑量30mg/d。坦度螺酮起始劑量5mg/d,兩周后加至治療劑量,最大劑量為30mg/d。治療8周,在治療前、治療后分別做陽性與陰性癥狀量表(Positive and Negative Syndrome Scale, PANSS)、威斯康星卡片分類測驗(Wisconsin Card Sorting Test, WCST)以及精神分裂癥認知功能成套測驗共識版(MATRICS Consensus Cognitive in Schizophrenia MCCB)進行療效分析和認知功能評定。同時給予副作用量表(Treatment Emergent Symptom Scale, TESS)評定檢測藥物的副作用。所有的數據用SPSS17.0進行統(tǒng)計分析。 結果：(1)研究組納入47例,脫落3例。對照組納入44例,脫落6例。基線時兩組間患者的發(fā)病年齡,首次住院年齡,病程、目前年齡以及受教育程度、PANSS各項評分以及各項認知測驗評分無顯著性差異。兩組患者的療效指標PANSS評分在治療結束時與基線比較均顯著降低(P均0.01),但兩組同一時點比較無統(tǒng)計學差異。 (2)對兩組患者治療前后精神分裂癥認知功能成套測驗共識版(MCCB)各項分值進行組內和組間比較發(fā)現(xiàn),研究組和對照組持續(xù)操作能力測驗(CPT-IP)、符號編碼(SC)、言語記憶(HVLT-R)、數字序列(DS)、視覺記憶(BVMT-R)、言語流暢性(CF)、情緒管理能力(MSCEIT-ME)有所改善(P0.01或0.05),且研究組較對照組同一時點比較持續(xù)操作能力測驗(CPT-IP)、符號編碼(SC)、言語記憶(HVLT-R)、數字序列(DS)、言語流暢性(CF)改善更顯著,兩組間比較有統(tǒng)計學意義(P均0.05或0.01)。研究組和對照組空間廣度(SS)、迷宮測驗(NAB-Mazes)言語流暢性(CF)、連線測驗(TMT)分值均有改善,但無統(tǒng)計學意義(p0.05)。 (3)對兩組患者治療前后威斯康星卡片分類測驗(WCST)進行組內和組間比較發(fā)現(xiàn),研究組和對照組完成分類數(Cc)、正確應答數(Rc)分值增加(p均0.01),錯誤應答數(Re)、持續(xù)性應答數(Rp)、持續(xù)性錯誤數(Rpe)、非持續(xù)性錯誤數(nRpe)分值降低(p0.05或0.01),且增加或降低均有統(tǒng)計學意義。且研究組較對照組同一時點在完成分類數、正確應答數、錯誤應答數、非持續(xù)性錯誤數4項改善中占有優(yōu)勢(p0.05或0.01)。而完成第一分類所需應答數(Rf),概念化水平應答百分比(Rf%),不能維持完整分類數(FM)、學習到學會(L-L)兩組雖然有所改善,但無統(tǒng)計學意義。 (4)副作用比較：治療過程中,兩組均出現(xiàn)不同程度的不良反應。對照組出現(xiàn)興奮激越的例數明顯多于研究組(p0.05),其他副作用差異無顯著性。 (5)相關分析結果顯示：患者的陽性癥狀、一般病理癥狀和各項認知測驗結果均無相關性。陰性癥狀和語言記憶、符號編碼、持續(xù)操作、情緒管理、數字序列、MCCB總分呈顯著相關性(p0.01),與持續(xù)性應答、持續(xù)性錯誤呈正相關(p0.01)。附加癥狀和符號編碼、情緒管理呈負相關(p0.05)。PANSS總分和符號編碼、情緒管理、語言記憶、MCCB總分呈負相關(p0.01),和持續(xù)性應答、持續(xù)性錯誤呈正相關(p0.01)。受教育程度和符號編碼、語言記憶、情緒管理、MCCB總分、持續(xù)性應答、持續(xù)性錯誤密切相關(p0.05或0.01)。 (6)多元逐步回歸分析顯示：文化程度、陰性癥狀為精神分裂癥患者的認知功能的主要影響因素。 結論：1.阿立哌唑聯(lián)用坦度螺酮或單獨應用阿立哌唑均可有效改善精神分裂癥患者的精神癥狀。 2.阿立哌唑聯(lián)用坦度螺酮較單用阿立哌唑改善女性精神分裂癥患者的認知功能。 3.受教育程度、陰性癥狀和PANSS總分與認知功能有顯著的相關性。受教育程度、陰性癥狀為主的精神分裂癥患者存在顯著的認知障礙。
[Abstract]:Objective: To investigate the effect of aripiprazole combined with tansspirone on cognitive function in female patients with schizophrenia.
Methods: 100 female patients with schizophrenia were randomly divided into two groups: the study group (aripiprazole combined with tamsulosone), the control group (aripiprazole), the initial dose of aripiprazole 15 mg / d, two weeks later to the treatment dose 20 mg / d, the maximum dose 30 mg / D. the initial dose of tamsulosone 5 mg / d, two weeks later to the treatment dose. The maximum dose was 30mg/d for 8 weeks. Positive and Negative Syndrome Scale (PANSS), Wisconsin Card Sorting Test (WCST) and Cognitive Function Test Consensus in Schizophren were administered before and after treatment. IAMCCB was evaluated for efficacy and cognitive function. Treatment Emergent Symptom Scale (TESS) was used to assess the side effects of the drugs. All data were analyzed with SPSS 17.0.
Results: (1) 47 patients were enrolled in the study group, 3 patients were exfoliated, 44 patients in the control group and 6 patients were exfoliated. Compared with baseline, there was a significant decrease (P = 0.01), but there was no significant difference between the two groups at the same time point.
(2) Comparing the scores of cognitive function test consensus version (MCCB) before and after treatment, the study group and the control group showed CPT-IP, SC, HVLT-R, DS, BVMT-R, CF, and emotional management ability. MSCEIT-ME was improved (P 0.01 or 0.05), and the improvement of CPT-IP, SC, HVLT-R, DS, CF was more significant in the study group than in the control group at the same time point. There was significant difference between the two groups (P 0.05 or 0.01). The scores of NAB-Mazes and TMT were all improved, but there was no significant difference (p0.05).
(3) Wisconsin Card Classification Test (WCST) before and after treatment was compared between the two groups. The results showed that the study group and the control group completed classification number (Cc), correct response number (Rc) score increased (p 0.01), error response number (Re), persistent response number (Rp), persistent error number (Rpe), non-persistent error number (nRpe) score decreased (p 0.05 or 0.05). Compared with the control group at the same time point, the study group had an advantage (p0.05 or 0.01) in completing the four improvements of classification number, correct response number, error response number and non-persistent error number, while the response number needed to complete the first classification (Rf), conceptual level response percentage (Rf%) could not maintain the complete classification number (F). M), although the two groups of learning and learning (L-L) improved, but there was no statistical significance.
(4) Side effects: In the course of treatment, there were different degrees of adverse reactions in both groups. The number of cases of excitatory agitation in the control group was significantly higher than that in the study group (p0.05), and there was no significant difference in other side effects.
(5) Correlation analysis showed that the positive symptoms, general pathological symptoms and cognitive test results were not correlated. Negative symptoms and language memory, symbol encoding, continuous operation, emotional management, number sequence, total score of MCCB were significantly correlated (p0.01), and persistent response, persistent error were positively correlated (p0.01). Symbol coding, emotional management was negatively correlated (p0.05). PANSS total score and symbol coding, emotional management, language memory, MCCB total score was negatively correlated (p0.01), and persistent response, persistent error was positively correlated (p0.01). Educational level and symbol coding, language memory, emotional management, MCCB total score, persistent response, persistent error were closely related (p0.05). Or 0.01).
(6) Multivariate stepwise regression analysis showed that educational level and negative symptoms were the main influencing factors of cognitive function in schizophrenic patients.
Conclusion: 1. Aripiprazole combined with tamsulosone or aripiprazole alone can effectively improve the mental symptoms of schizophrenic patients.
2. Aripipiprazole combined with tamsulosone can improve the cognitive function of female schizophrenic patients compared with aripiprazole alone.
3. Educational level, negative symptoms and PANSS scores were significantly correlated with cognitive function. Schizophrenic patients with negative symptoms had significant cognitive impairment.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R749.3

【參考文獻】

相關期刊論文 前10條

1 曾凡新,傅潔民,董志;非典型抗精神病藥的受體藥理學研究進展[J];中國臨床藥理學雜志;2003年05期

2 盛建華;宋振華;施慎遜;袁一萍;;精神分裂癥的記憶功能及其影響因素[J];精神醫(yī)學雜志;2007年03期

3 宋振華;盛建華;施慎遜;虞一萍;;精神分裂癥患者的認知功能及其影響因素[J];精神醫(yī)學雜志;2008年05期

4 繆金生;;坦度螺酮治療記憶障礙的研究進展[J];四川精神衛(wèi)生;2008年01期

5 趙靖平;抑郁癥藥物治療的一些近代觀點[J];四川精神衛(wèi)生;1999年01期

6 翁史e，

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