目的 探讨盐酸鲁拉西酮片联合舒必利片治疗精神分裂症的临床疗效。方法 选取2020年2月-2022年11月在上海市静安区精神卫生中心就诊的120例精神分裂症患者,按照计算机随机排列法分为对照组和治疗组,每组各60例。对照组患者口服舒必利片,首次剂量1片/次,3次/d,治疗7 d后增加至3片/次,3次/d。治疗组患者在对照组基础上口服盐酸鲁拉西酮片,1片/次,1次/d。两组患者连续治疗2个月。观察两组的临床疗效,比较两组的阳性与阴性症状量表(PANSS)评分、精神分裂症生活质量量表(SQLS)评分以及血清中催乳素(PRL)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平。结果 治疗后,治疗组的总有效率为91.67%,对照组的总有效率为78.33%,组间比较差异有统计学意义(P<0.05)。治疗后,两组的PANSS各项评分均显著降低(P<0.05),且治疗组PANSS各项评分较对照组更低(P<0.05)。治疗后,两组的SQLS各项评分显著降低(P<0.05),治疗组SQLS各项评分降低程度高于对照组(P<0.05)。治疗后,两组的血清PRL水平高于治疗前,血清IL-6、IL-17水平低于治疗前(P<0.05);治疗后,治疗组的血清IL-6、IL-17水平低于对照组(P<0.05)。结论 盐酸鲁拉西酮片联合舒必利片可提高精神分裂症的临床疗效,减轻患者精神症状,提高生活质量,减轻炎症反应,且药物安全性良好。

Objective To investigate the clinical effect of Lurasidone Hydrochloride Tablets combined with Sulpiride Tablets in treatment of schizophrenia. Methods Patients (120 cases) with schizophrenia in Shanghai Jing'an District Mental Health Center from February 2020 to November 2022 were divided into control and treatment groups according to the computer random arrangement method, and each group had 60 cases. Patients in the control group were po administered with Sulpiride Tablets, initial dose of 1 tablet/time, three times daily. After 7 d of treatment, the dose was increased to 3 tablets/time, three times daily. Patients in the treatment group were po administered with Lurasidone Hydrochloride Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and PANSS scores, SQLS scores, the serum levels of PRL, IL-6, and IL-17 in two groups were compared. Results After treatment, the total effective rate of the treatment group was 91.67%, while the total effective rate of the control group was 78.33%, and there was a statistically significant difference between the groups (P < 0.05). After treatment, the scoring of each item in PANSS of two groups were significantly reduced (P < 0.05), and the scoring of each item in PANSS of the treatment group were lower than those of the control group (P < 0.05). After treatment, the scoring of each item in SQLS of two groups were significantly decreased (P < 0.05), and the scoring of each item in SQLS in the treatment group was higher than that in the control group (P < 0.05). After treatment, the serum levels of PRL in two groups were higher than before treatment, while the serum levels of IL-6 and IL-17 were lower than before treatment (P < 0.05). After treatment, the serum levels of IL-6 and IL-17 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Lurasidone Hydrochloride Tablets combined with Sulpiride Tablets can improve the efficacy of schizophrenia, further reduce the psychiatric symptoms, improve the quality of life, alleviate inflammatory reactions, with good drug safety.

R971

上海市静安区精神卫生中心医学科研课题(2019KY04)