目的 觀察氨磺必利聯(lián)合奧氮平改善精神分裂癥患者認知功能的臨床療效。方法 將2013年10月-2015年10月在上海市寶山區(qū)精神衛(wèi)生中心住院的精神分裂癥患者61例隨機分為對照組(31例)和治療組(30例),對照組口服奧氮平片,起始劑量10 mg/d,依患者病情及癥狀,1周內(nèi)增加至15~20 mg/d,平均給藥劑量(18.75±1.13)mg/d;治療組在對照組基礎上口服氨磺必利片,起始劑量0.1 g/d,根據(jù)具體病情,1周內(nèi)增加至0.1~0.3 g/d,平均給藥劑量(0.26±0.06)g/d。兩組均連續(xù)治療8周。比較兩組治療前后的陽性癥狀與陰性癥狀量表(PANSS)、韋氏記憶量表(WMS)、威斯康星卡片分類測驗(WCST)評定。結果 治療4周后,兩組的陽性癥狀評分、一般精神病理癥狀評分和總分較治療前均顯著改善(P<0.05、0.01);且治療組陰性癥狀分值和總分改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學意義(P<0.05)。治療8周后,兩組的陽性癥狀評分、陰性癥狀評分、一般精神病理癥狀評分和總分均較治療前顯著改善,同組治療前后差異有統(tǒng)計學意義(P<0.05)。兩組治療后比較差異無統(tǒng)計學意義。治療8周后,兩組的正確數(shù)、完成分類數(shù)顯著升高,隨機錯誤數(shù)顯著降低,兩組比較差異具有統(tǒng)計學意義(P<0.05);且治療組的WCST評分改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學意義(P<0.05)。治療8周后,兩組的WMS評分差異無統(tǒng)計學意義。結論 氨磺必利聯(lián)合奧氮平能夠顯著改善精神分裂癥患者的認知功能,具有一定的臨床推廣應用價值。

Objective To observe the clinical effects of amisulpride combined with olanzapine in improvement of cognitive function in patients with schizophrenia. Methods Patients (61 cases) with schizophrenia in Mental Health Center of Baoshan District in Shanghai from October 2013 to October 2015 were randomly divided into control group (31 cases) and treatment group (30 cases). The patients in the control group were po administered with Olanzapine Tablets 10 mg/d at beginning, then gradually added to 15 - 20 mg/d according to patient's condition and symptoms in one week, and the average dosage was (18.75 ± 1.13) mg/d. Patients in the treatment group were po administered with Amisulpride Tablets 0.1 g/d at beginning, then gradually added to 0.1 - 0.3 g/d according to patient's condition in one week, and the average dosage was (0.26 ± 0.06) mg/d. Two groups were treated for 8 weeks. Positive and negative syndrome scale (PANSS), Wechsler memory scale (WMS), and Wisconsin card sorting test (WCST) were compared before and after treatment. Results After treatment for 4 weeks, positive symptom scores, general mental pathological symptom scores, and total scores in both groups were improved significantly (P < 0.05, 0.01). The negative symptom scores and total scores in the treatment group were significantly better than those in the control group, and there were significant differences between two groups (P < 0.05). After treatment for 8 weeks, positive symptom scores, negative symptom scores, general mental pathological symptom scores, and total scores in both groups were improved significantly, and the differences were statistically significant in the same group (P < 0.05). There was no significant difference between two groups. After treatment for 8 weeks, the number of correct responses and categories were significantly increased, but the number of random errors was significantly decreased, and the differences were statistically significant in the same group (P < 0.05). The WCST scores in the treatment group were significantly better than those in the control group, and there were significant differences between two groups (P < 0.05). After treatment for 8 weeks, there was no significant difference between two groups. Conclusion Amisulpride combined with olanzapine has significant clinical curative effect in improvement of cognitive function in patients with schizophrenia, which has a certain clinical application value.