目的 觀察舒必利片聯(lián)合奧氮平片治療難治性精神分裂癥的療效情況。方法 選取2017年6月-2018年7月上海市精神衛(wèi)生中心治療的81例難治性精神分裂癥患者作為研究對象。根據(jù)患者就診時間的差異，將患者分為對照組（33例）和觀察組（48例）對照組患者口服奧氮平片，初始用藥劑量為10 mg/次，1次/d。用藥劑量在1周內(nèi)逐漸增至20 mg/次，1次/d。觀察組在對照組的基礎(chǔ)上口服舒必利片，舒必利片初始用藥劑量為100 mg/次，2次/d。用藥劑量在1周內(nèi)逐漸增至300 mg/次，2次/d。兩組患者均接受連續(xù)3個月的藥物治療。觀察兩組患者的臨床療效和不良反應(yīng)發(fā)生情況，同時比較兩組治療前后的陽性、陰性癥狀量表（PANSS）評分、威斯康星卡片分類檢測（WCST）評分。結(jié)果 治療后，觀察組和對照組的治療總有效率分別為93.75%、69.70%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者PANSS評分均顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組PANSS評分明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者持續(xù)、非持續(xù)錯誤數(shù)評分均顯著降低，完成分類數(shù)、總正確數(shù)評分均顯著升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，觀察組WCST各維度評分均明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療期間，對照組不良反應(yīng)發(fā)生率為36.36%，與觀察組31.25%比較無明顯差異。結(jié)論 舒必利片聯(lián)合奧氮平片可以有效改善難治性精神分裂癥患者的認(rèn)知功能，且安全性較高，具有廣闊的應(yīng)用前景，值得進(jìn)行推廣應(yīng)用。

Objective To observe the efficacy of Sulpiride Tablets combined with Olanzapine Tablets in treatment of refractory schizophrenia. Methods Patients (81 cases) with refractory schizophrenia in Shanghai Mental Health Center from June 2017 to July 2018 were included in this study. According to the difference in hospital admission time, patients were devided into control group (33 cases) and observation group (48 cases). Patients in the control group were po administered with Olanzapine Tablets, the initial dose was 10 mg/time, once daily, and the dosage was gradually increased to 20 mg/time, and once daily within 1 week. Patients in the observation group were po administered with Sulpiride Tablets on the basis of control group, the initial dose of Sulpiride Tablets was 100 mg/time, twice daily, and gradually increased to 300 mg/time, twice daily within 1 week. Patients in two groups were treated for 3 months. The clinical efficacy and adverse reactions in two groups were observed, and the PANSS score and WCST score before and after treatment were compared. Results After treatment, the total effective rate of treatment in the observation group and the control group was 93.75% and 69.70%, respectively, the difference between two groups was statistically significant (P<0.05). After treatment, PANSS scores in two groups were significantly decreased, and the difference before and after treatment in the same group was statistically significant (P<0.05). And the PANSS score in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the scores of persistent and non-persistent errors number in two groups were significantly decreased, and the scores of completed classifications number and the total number of correct scores were significantly increased, the differences before and after treatment in the same group were statistically significant (P<0.05). After treatment, the WCST scores of each dimension in the observation group were significantly better than those in the control group, and the difference between two groups was statistically significant (P<0.05). During the treatment, the incidence of adverse reactions in the control group was 36.36%, with no significant difference compared with 31.25% in the observation group. Conclusion Sulpiride Tablets combined with Olanzapine Tablets can effectively improve the cognitive function of patients with refractory schizophrenia, and the safety is high, it has broad application prospect and is worth popularizing.

R971

上海市科學(xué)技術(shù)委員會科技計(jì)劃項(xiàng)目（17401932600）；上海市精神衛(wèi)生中心院級課題（2013-YJ-10）