内科

目的探讨阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的精神分裂症患者的疗效、安全性及对认知功能的影响。方法将48例以阴性症状为主的慢性精神分裂症患者随机分为研究组和对照组，每组24例。研究组给予阿立哌唑联合小剂量氯氮平治疗，对照组仅给予常规剂量氯氮平治疗，疗程12周；采用阳性与阴性症状量表（PANSS）、治疗中的副反应量表（TESS）评定疗效和副反应，采用威斯康星卡片（WCST）和连续作业测验（CPT）评定患者的认知功能。结果治疗12周后，两组患者PANSS总分、三个因子分均低于治疗前（P＜0.05）；研究组PANSS总分、一般病理分、阴性症状分低于对照组（P＜0.05）；研究组WCST评定总错误数、持续反应数、持续错误数、正确应答数与对照组比较，差异均具有统计学意义（P均＜0.05）。研究组与对照组的CPT评定正确数值、反应时比较差异有统计学意义（P＜0.05），研究组不良反应低于对照组（P＜0.05）。结论阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的慢性精神分裂症患者，可明显改善精神分裂症患者的阴性症状及认知功能；与单用常规剂量氯氮平相比安全性更好。

ObjectiveTo study the cognitive function, efficacy and safety of Aripiprazole combined with low doses of Clozapine for the treatment of schizophrenia with negative symptoms.Methods48 schizophrenia patients with negative symptoms were randomly divided into two groups, the study group(24 cases) were treated with aripiprazole combined with low doses of clozapine and the control group(24 cases) were given clozapine in regucar dose, the course of treatment was 12 weeks,clinical efficacy and side effects were assessed with PANSS and TESS,while cognitive function were evaluated by WCST and CPT.ResultsThe score of PANSS, factors (postive symptoms,negative symptoms and general pathological) in the two groups were lower at the end of the treatment （P＜0.05 ); compared with the control group ,the score of PANSS,general pathological, negative symptoms in the study group were lower (P <0.05); the number of indicators of the WCST and CPT were improver with lower adverse reactions in the study group (P <0.05) .ConclusionsCombing Aripiprazole and low doses of Clozapine can obviously improve negative symptoms and cognitive function of schizophrenia， and more secure than using clozapine alone in regular dose.