Effect of amisulpride on score of Positive and Negative Syndrome Scale, prolactin level, body mass and quality of life in patients with schizophrenia
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摘要:目的 探讨氨磺必利对精神分裂症患者阳性症状与阴性症状量表(PANSS)评分、催乳素(PRL)水平、体质量及生活质量的影响。方法 选取80例精神分裂症患者, 按照随机数字法分为对照组(n=40)与观察组(n=40)。对照组给予利培酮治疗，观察组给予氨磺必利治疗。比较2组临床疗效、PANSS评分、PRL水平、体质量、生活质量(SF-36)评分及不良反应发生率。结果 2组总有效率比较无显著差异(P>0.05)。观察组治疗后阴性症状评分和总分均显著低于对照组(P < 0.05), 2组阳性症状、精神病理评分比较无显著差异(P>0.05)。观察组治疗后PRL水平显著低于对照组(P < 0.05), 2组体质量比较无显著差异(P>0.05)。观察组治疗后总体健康、社会功能、情感职能、机体功能评分均显著高于对照组(P < 0.05), 2组生理职能、躯体疼痛、活力、精神健康评分均无显著差异(P>0.05)。观察组治疗后不良反应发生率为10.00%, 显著低于对照组的30.00%(P < 0.05)。结论 氨磺必利与利培酮疗效相当，但氨磺必利对精神分裂症患者阴性症状的疗效更佳，且能降低PRL水平，提高生活质量。Abstract:Objective To explore effect of amisulpride on score of Positive and Negative Syndrome Scale (PANSS), prolactin (PRL) level, body mass and quality of life in patients with schizophrenia.Methods Totally 80 schizophrenia patients were randomly divided into control group (n=40) and observation group (n=40). The control group was given risperidone, while observation group was given amisulpride. The clinical efficacy, score of PANSS, PRL level, body mass, score of short-form health survey (SF-36) and incidence rate of adverse reactions were compared between the two groups.Results There was no significant difference in the total effective rate between the two groups (P>0.05). After treatment, the score of negative symptoms and total score in the observation group were significantly lower than those in the control group (P < 0.05), while there were no significant differences in the scores of positive symptoms and psychopathological status between the two groups (P>0.05). After treatment, the PRL level in the observation group was significantly lower than that in the control group (P < 0.05), and there was no significant difference in body mass between the two groups (P>0.05). After treatment, the scores of general health, social function, emotional function and body function in the observation group were significantly higher than those in the control group (P < 0.05). There were no significant differences in the scores of physiological function, physical pain, vitality and mental health between the two groups (P>0.05). The incidence rate of adverse reactions in the observation group was 10.00%, which was significantly lower than 30.00% in the control group (P < 0.05).Conclusion Amisulpride and risperidone have the same effect in treating schizophrenia patients, but the effect of amisulpride on negative symptoms is better, and it can reduce PRL level and improve the quality of life.
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表 1 2组临床疗效比较[n(%)]
组别 n 显效 有效 无效 总有效 观察组 40 21(52.50) 14(35.00) 5(12.50) 35(87.50) 对照组 40 20(50.00) 13(32.50) 7(17.50) 33(82.50) 
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表 2 2组PANSS评分比较(x±s)
分 组别 阳性症状 阴性症状 精神病理 总分 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组(n=40) 24.63±5.38 12.10±3.05 21.60±4.92 6.47±1.33* 28.45±6.37 9.56±3.07 74.26±10.50 27.61±5.23* 对照组(n=40) 25.40±5.41 12.74±4.12 22.10±5.03 11.29±3.06 29.21±6.40 10.42±3.14 75.02±10.53 42.79±8.20 与对照组比较, *P < 0.05。
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表 3 2组PRL水平、体质量比较(x±s)
组别 n 催乳素/(mIU/L) 体质量/kg 治疗前 治疗后 治疗前 治疗后 观察组 40 232.35±70.18 234.56±73.08* 62.70±10.39 63.29±11.17* 对照组 40 230.96±70.05 415.87±90.23 63.12±10.43 63.25±11.14 与对照组比较, *P < 0.05。
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表 4 2组生活质量评分比较(x±s)
分 组别 时点 机体功能 生理职能 躯体疼痛 活力 社会功能 情感职能 精神健康 总体健康 观察组(n=40) 干预前 46.32±4.60 58.15±6.22 40.62±5.41 47.74±4.68 51.62±4.55 47.34±4.52 54.32±4.61 53.69±4.58 干预后 64.71±7.23*# 65.34±7.55# 51.36±6.54# 58.30±6.84# 60.11±6.70*# 57.94±6.67*# 62.38±6.14# 65.63±7.40*# 对照组(n=40) 干预前 16.27±4.57 58.63±6.27 40.88±5.46 48.12±4.73 52.01±4.57 48.09±4.57 55.11±4.64 53.78±4.63 干预后 60.05±5.93* 64.18±6.29* 50.71±6.72* 57.05±6.60* 56.14±5.57* 52.85±5.77* 60.96±5.81* 58.90±5.66* 与干预前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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