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In this study 60 female schizo- phrenic patients were treated,Gr- oup A was treated with antipsych- otic drugs combining with insulin hypoglycemia,while group B was only treated with antipsychotic d- rugs,They were opserved by the rating methods of IV grade thera- peutic effect, The results show that in both groups there is no statistical sign- ificance in comparison of the imm- ediate effect,the feature of contr- olling the prominient psychiatric symptoms,the time needed for the same level of improvement,the... In this study 60 female schizo- phrenic patients were treated,Gr- oup A was treated with antipsych- otic drugs combining with insulin hypoglycemia,while group B was only treated with antipsychotic d- rugs,They were opserved by the rating methods of IV grade thera- peutic effect, The results show that in both groups there is no statistical sign- ificance in comparison of the imm- ediate effect,the feature of contr- olling the prominient psychiatric symptoms,the time needed for the same level of improvement,the d- aily-dose of antipsychotic drugs used,the lowering extent of the total counts and the count of each factor,the lowering speed of the total counts and the counts of fac- tors except anxiety-depression,the speed of having gotten prominient effect is slower in group A as co- mpared with group B,while the s- peed of having improved the anxi- ous and depressive symptoms is fa- ster in A as compared with B. The authors suggest that the t- herapy of antipsyehotic drugs com- bining with insulin hypoglycemic t- reatment on schizophrenia should be give up. 本文报道了抗精神病药物合并胰岛素低血糖与抗精神病药物分组对照治疗女性精神分裂症病人(各30例)。用BPRS量表评分法和四级疗效标准评定为观察方法。结果提示,在即期疗效、好转方式,达到同一缓解水平所用治疗日数和抗精神病药的日使用量、BPRS总分和各因子分的减分幅度以及总分和除焦虑忧郁项以外的其它四项因子的减分速度等方面,合并治疗均无明显优点,其达显进疗效反而慢于对照组,而对焦虑忧郁症状的缓解较快于对照组。作者认为,从即期疗效上看,合并胰岛素低血糖疗法在精神分裂症治疗中无明显优势,应予淘汰。 To screen factors associated with therapeutic efficacy of clozapine, 30 first episode schizophrenics were examined. Patients received fixed dose clozapine in a 12 week trial. Wisconsin Card Sorting Test (WCST) was tested before treatment. The Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS) and Global Assessment Function were tested and the levels of blood clozapine and prolactin were measured at the baseline and at the end of 1, 2, 4, 8, 12 week respectively.... To screen factors associated with therapeutic efficacy of clozapine, 30 first episode schizophrenics were examined. Patients received fixed dose clozapine in a 12 week trial. Wisconsin Card Sorting Test (WCST) was tested before treatment. The Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS) and Global Assessment Function were tested and the levels of blood clozapine and prolactin were measured at the baseline and at the end of 1, 2, 4, 8, 12 week respectively. The results showed that the therapeutic effectiveness of clozapine was positively related with 8 factors, including the high scores of thought disorder and activation factor of BPRS before treatment, low basal prolactin level, old age of first episode, more perseverative responses and less trials to complete 1st category of WCST, high scores of attention disorder and low thought poverty factor of SANS before treatment. It suggested that clozapine might be selected reasonably in first episode schizophrenics according to above 8 factors. 为筛选与氯氮平治疗效应相关的影响因素、指导临床合理选药,对30例首发精神分裂症氯氮平治疗效应的影响因素进行筛选与评估。入组患者均按规定剂量给药,选用简明精神病评定量表(BPRS)、阴性症状评定量表(SANS)、总体功能评定量表进行临床评定,动态观察治疗前及治疗后第1,2,4,8,12周的病情变化,同时作血药浓度、催乳素和治疗前威斯康辛卡片分类测验(WCST)测查。结果显示,治疗前BPRS的思维障碍因子分及激活性增高因子分高、基础催乳素水平低、首发年龄大、WCST的保存记忆反应数多而完成第一套范畴数少、SANS的注意障碍因子分高而思维贫乏因子分低等8项指标,对氯氮平治疗12周时的疗效有正性影响。提示在首发精神分裂症的治疗中,可根据这8项影响因素合理选用氯氮平 Objective To study clinical efficacy of clozapine and its influence factors on the treatment of first episode schizophrenic patients Methods 30 first episode schizophrenic patients were regularly treated with clozapine The rating scales of brief psychiatric rating scale (BPRS), scale for the assessment of negative symptoms (SANS) , clinical global impressions scale (CGI) and global assessment function(GAF) were used to assess the effects of clozapine, and blood drug concentration,... Objective To study clinical efficacy of clozapine and its influence factors on the treatment of first episode schizophrenic patients Methods 30 first episode schizophrenic patients were regularly treated with clozapine The rating scales of brief psychiatric rating scale (BPRS), scale for the assessment of negative symptoms (SANS) , clinical global impressions scale (CGI) and global assessment function(GAF) were used to assess the effects of clozapine, and blood drug concentration, prolactin and wisconsin card sorting test (WCST) were measured before and during the first, second, fourth, eighth, twelfth weeks following the treatment courses Rusults Positive and negative symptoms were markly rapidly improved In addition, the patients who had more 400 μg/L of blood drug concentration, less 11 μg/L of baseline prolactin levels and good WCST manifestations would have good response to clozapine treatment Conclusion Clozapine should be used widely to treat first episode schizophrenic patients as first line antipsychotic drugs 目的 探讨氯氮平治疗首发精神分裂症的效能及影响因素对指导临床用药有很大的实用性。 方法 3 0例首发精神分裂症病人均按规定剂量给药 ,选用简明精神症状评定量表 (BPRS)、阴性症状评定量表 (SANS)、临床总体印象量表 (CGI)、总体功能评定量表 (GAF) ,在治疗前及治疗第1、2、4、8、1 2周进行临床评定及血药浓度、催乳素 (PRI)检测 ,治疗前威斯康辛卡片分类测验 (WC ST)。 结果 氯氮平对首发精神分裂症的阳性、阴性症状均有显著的疗效 ,且起效迅速。此外发现血药浓度大于 40 0 μg/L、基础PRL水平低于 1 1 μg/L、WCST检查表现好的患者 ,选用氯氮平治疗有好的疗效。 结论 氯氮平可作为较好的一线药物 ,广泛应用于首发精神分裂症的治疗
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