目的 研究氯普噻吨片联合氟哌啶醇片治疗难治性精神分裂症的临床疗效。方法 选取2018年6月-2019年6月在天津市安定医院治疗的100例难治性精神分裂症患者。将所有患者随机分为对照组和治疗组，每组各50例。对照组患者口服氟哌啶醇片，起始剂量1~2片/次，2~3次/d，逐渐增加至常用量5~20片/d，维持剂量2~10片/d。治疗组在对照组基础上口服氯普噻吨片，从小剂量开始，首次剂量25~50 mg/次，2~3次/d，以后逐渐增加至400~600 mg/d，维持量为100~200 mg/d。两组患者持续治疗3个月。观察两组患者临床疗效，比较两组的汉密顿抑郁量表（HAMD）评分、阴性和阳性症状量表（PANSS）评分和个人和社会功能量表（PSP）评分和血清学指标水平。结果 治疗后，对照组和治疗组的总有效率分别为78.00%、94.00%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者PSP评分显著升高，HAMD评分和PANSS评分显著降低（P<0.05）；且治疗组HAMD评分、PANSS评分和PSP评分改善较明显（P<0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、白细胞介素-1β（IL-1β）水平显著降低，胶质源性神经营养因子（GDNF）水平显著升高（P<0.05）；且治疗组血清NSE、MBP、IL-1β和GDNF水平改善较多（P<0.05）。结论 氯普噻吨片联合氟哌啶醇片治疗难治性精神分裂症具有较好的临床疗效，能够改善临床症状，缓解抑郁情绪，改善血清炎性因子水平，安全性较高。

Objective To study the curative effect of Chlorprothixene Tablets combined with Haloperidol Tablets in treatment of refractory schizophrenia. Methods Patients (100 cases) with refractory schizophrenia in Tianjin Anding Hospital from June 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Haloperidol Tablets, starting dosage 1-2 tablets/time, 2-3 times daily, then gradually increased to the commonly used dose of 5-20 tablets/d, and the maintenance dose was 2-10 tablets/d. Patients in the treatment group were po administered with Chlorprothixene Tablets on the basis of the control group, starting dosage 25-50 mg/time, 2-3 times daily, then gradually increased to the commonly used dose of 400-600 mg/d, and the maintenance dose was 100-200 mg/d. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and HAMD score, PANSS score, PSP score, and serological index level in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.00% and 94.00%, respectively, and there was difference between two groups (P < 0.05). After treatment, the PSP scores of two groups were significantly increased, but the HAMD score and PANSS score of two groups were significantly decreased (P < 0.05). And the HAMD score, PANSS score, and PSP score of the treatment group were significantly improved more than those of the control group (P < 0.05). After treatment, the levels of NSE, MBP, and IL-1β in two groups were significantly decreased, but the levels of GDNF in two groups increased significantly (P < 0.05). And the levels of NSE, MBP, IL-1β, and GDNF in the treatment group were significantly improved more than those in the control group (P < 0.05). Conclusion Chlorprothixene Tablets combined with Haloperidol Tablets has clinical curative effect in treatment of refractory schizophrenia, can improve the clinical symptoms, relieve depression, improve the level of serum inflammatory factors.

R971

国家重点研发计划课题任务（2018YFC1314304）