目的 探讨牛黄宁宫片联合帕利哌酮治疗青少年精神分裂症的临床疗效与安全性。方法 选取内蒙古自治区精神卫生中心2017年3月—2018年3月收治的青少年精神分裂症患者141例，随机分成对照组（70例）和治疗组（71例）。对照组口服帕利哌酮缓释片，1片/次，1次/d；治疗组患者在对照组基础上口服牛黄宁宫片，3片/次，3次/d。两组患者均连续治疗6周。观察两组患者临床疗效，同时比较治疗前后两组患者阳性与阴性症状量表（PANSS）、个人与社会表现（PSP）和简明精神病评定量表（BPRS）评分，血清指标水平及不良反应情况。结果 治疗后，对照组和治疗组临床有效率分别为84.29%和95.77%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者PANSS和BPRS评分均显著降低（P<0.05），PSP评分显著升高（P<0.05），且治疗组PANSS、PSP和BPRS评分明显好于对照组（P<0.05）。治疗后，两组患者血清神经元特异性烯醇化酶（NSE）、同型半胱氨酸（Hcy）以及D-二聚体（D-D）水平均显著降低（P<0.05），且治疗组NSE、Hcy及D-D水平明显低于对照组（P<0.05）。治疗期间，治疗组不良反应发生率为2.82%，显著低于对照组患者的12.86%，两组比较差异具有统计学意义（P<0.05）。结论 牛黄宁宫联合帕利哌酮治疗青少年精神分裂症疗效好，安全性高，同时能够显著减轻青少年精神分裂症病情，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy and safety of Niuhuang Ninggong Tablets combined with paliperidone in treatment of adolescent schizophrenia. Methods Patients (141 cases) with schizophrenia in Mental Health Center of Inner Mongolia Autonomous Region from March 2017 to March 2018 were randomly divided into control (70 cases) and treatment (71 cases) groups. Patients in the control group were po administered with Paliperidone Extended-Release Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Niuhuang Ninggong Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacy was evaluated, and the PANSS, PSP and BPRS scores, the serum indicators levels and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 84.29% and 95.77% respectively, and there were differences between two groups (P<0.05). After treatment, the PANSS and BPRS scores in two groups were significantly decreased (P<0.05), but PSP scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum NSE, Hcy and D-D levels in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). During the treatment, the adverse reactions rate in the treatment group was 2.82%, which was significantly lower than 12.86% in treatment the group, with significant difference between two groups (P<0.05). Conclusion Niuhuang Ninggong Tablets combined with paliperidone is effective and safe in treatment of adolescent schizophrenia, can significantly reduce the schizophrenia, which has a certain clinical application value.