摘要
目的 探讨肌注氟哌啶醇合用利培酮对急性期精神分裂症患者激越行为的疗效.方法 将符合《中国精神障碍分类与诊断标准（第3版）》（CCMD-3）诊断标准的165名新入院伴有兴奋冲动行为的精神分裂症患者,采用随机数字表法分为3组,利培酮合并氟哌啶醇组（A组）、利培酮合并氯硝西泮组（B组）和氟哌啶醇组（C组）,观察2周.采用阳性及阴性评定量表（PANSS）兴奋激越因子评定精神症状（激越行为）.结果 PANSS-兴奋激越各单项分的时间因素主效应均具有统计学意义（F=896.936 ～1484.087,P＜0.01）,且时间与治疗因素之间交互效应均有统计学意义（F=6.962～ 41.495,P＜0.01）.治疗因素主效应仅在敌对单项分上有统计学意义（F=3.455,P=0.034）.重复测量方差分析显示,3组患者组内不同时间点各单项得分比较,差异有统计学意义（F=227.991～615.334,P＜0.01）.3组患者组间各单项分多元方差分析表明,治疗前：差异无统计学意义（F=0.073～1.473,P＞0.05）;治疗后24h末：差异均有统计学意义（F=5.386 ～8.075,P＜0.01）;1周末：除愤怒、延迟满足困难外,差异均有统计学意义（F=7.357～8.546,P＜0.01）;2周末,除兴奋外,差异无统计学意义（F=0.616～1.205,P＞0.05）.结论 利培酮合并氟哌啶醇短期肌注可作为临床处理精神分裂症急性期兴奋激越手段之一.
Objective To compare the efficacy of risperidone combining short.- term intramuscular haloperidol or clonazepam and intramuscular haloperidol in the treatment of the agitated behavior of patients in the acute phase of schizophrenia. Methods 165 patients associated with impulsive behavior who met the diagnostic criteria of CCMD - 3 for schizophrenia were randomly divided into three groups. Group A was treated with risperidone combining short - term intramuscular haloperidol, B with risperidone combining short - term intramuscular donazepam and C with only haolperidol . During a two - week observation period, the efficacy was evaluated by PANSS. Results The effect of interaction between time and groups was statistically significant by repetitive measure ANOVA. The differences between time （ F = 896. 936 ～ 1484. 087, P 〈 0.01 ） on all items of excitement of PANSS and groups （ F = 3. 455, P 〈 0.01 ） on only hostility item indicated statistical significance. Intra - group comparison ： All items of excitement of PANSS had signifi- cant differences （ F = 227. 991 - 615. 334 ,P 〈 0.01 ） between time - points of evaluation by repetitive measure ANOVA and LSD. At each time -point by multivariate analysis of variance and LSD the comparisons on each item of excitement of PANSS between three groups show that no significant difference before treatment （ F = 0. 073 ～1. 473, P 〉 0.05 ）, significant difference after 24 hours of treatment （ F = 5. 386 ～ 8. 075, P 〈 0.01 ） and after one - week of treatment （ F = 7. 357～ 8. 546, P 〈 0.01 ） except anger and delayed gratification difficulties; At the end of observation period, there were no significant difference among three groups （F = 0. 616 ～ 1. 205, P 〉 0.05 ） except excitement. Conclusion Risperidone combined short - term haloperidol intramuscular could be a good means of con- trolling agitated behavior of patients in the acute phase of schizophrenia.
出处
《四川精神卫生》
2014年第4期303-307,共5页
Sichuan Mental Health
基金
安徽省卫生厅医学科研项目(09C178)
关键词
精神分裂症
利培酮
氯硝安定
氟哌啶醇
短期肌注
激越行为
Schizophrenia
Risperidone
Clonazepam
Haloperidol
Short - term intramuscular
Agitated behavior
作者简介
刘云，E-mail：psyah@126．com
