目的 研究氯普噻噸片聯(lián)合氟哌啶醇片治療難治性精神分裂癥的臨床療效。方法 選取2018年6月-2019年6月在天津市安定醫(yī)院治療的100例難治性精神分裂癥患者。將所有患者隨機分為對照組和治療組，每組各50例。對照組患者口服氟哌啶醇片，起始劑量1~2片/次，2~3次/d，逐漸增加至常用量5~20片/d，維持劑量2~10片/d。治療組在對照組基礎上口服氯普噻噸片，從小劑量開始，首次劑量25~50 mg/次，2~3次/d，以后逐漸增加至400~600 mg/d，維持量為100~200 mg/d。兩組患者持續(xù)治療3個月。觀察兩組患者臨床療效，比較兩組的漢密頓抑郁量表（HAMD）評分、陰性和陽性癥狀量表（PANSS）評分和個人和社會功能量表（PSP）評分和血清學指標水平。結(jié)果 治療后，對照組和治療組的總有效率分別為78.00%、94.00%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者PSP評分顯著升高，HAMD評分和PANSS評分顯著降低（P<0.05）；且治療組HAMD評分、PANSS評分和PSP評分改善較明顯（P<0.05）。治療后，兩組血清神經(jīng)元特異性烯醇化酶（NSE）、髓鞘堿性蛋白（MBP）、白細胞介素-1β（IL-1β）水平顯著降低，膠質(zhì)源性神經(jīng)營養(yǎng)因子（GDNF）水平顯著升高（P<0.05）；且治療組血清NSE、MBP、IL-1β和GDNF水平改善較多（P<0.05）。結(jié)論 氯普噻噸片聯(lián)合氟哌啶醇片治療難治性精神分裂癥具有較好的臨床療效，能夠改善臨床癥狀，緩解抑郁情緒，改善血清炎性因子水平，安全性較高。

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

國家重點研發(fā)計劃課題任務（2018YFC1314304）