美金刚辅助治疗精神分裂症阴性症状的对照研究

Accessory Effect of Memantine on Negative Symptoms of Schizophrenia Patients: A Controlled Study

摘要: 目的：观察美金刚辅助治疗精神分裂症阴性症状的有效性及安全性。方法：通过随机数字表法，我们选取64名阴性症状为主的精神分裂症患者随机分为两组，维持原有的抗精神病药物不变，一组联用美金刚，另一组联用安慰剂，美金刚第一周10 mg/d，第二周20 mg/d，疗程12周，最终完成60例。分别于治疗前和治疗第4、8、12周末使用阴性症状量表(SANS)及阳性和阴性症状量表(PANSS)评估治疗效果，同时使用简易智力状态检查量表(MMSE)评估认知改变，并使用不良反应量表(TESS)评估安全性。结果：研究组SANS总分、思维贫乏分量表、注意障碍分量表及PANSS总分、PANSS阴性因子总分均在第12周末显著低于对照组(P < 0.05或P < 0.01)；研究组SANS总分、思维贫乏分量表、注意障碍分量表及PANSS总分、PANSS阴性因子总分从第8周末开始显著低于治疗前(P < 0.05或P < 0.01)。研究组MMSE得分在第12周末显著高于对照组(P < 0.05)及治疗前(P < 0.01)，两组间不良反应差异无统计学意义(P > 0.05)。结论：美金刚辅助治疗对治疗精神分裂症阴性症状有增效作用，安全性好。

Abstract: Objective: To observe the efficacy and safety of memantine in the adjunctive treatment of negative symptoms in schizophrenia. Methods: By means of randomized numerical table method, we select-ed 64 schizophrenic patients with predominantly negative symptoms and randomly divided them into two groups, maintaining the original antipsychotic medication unchanged, one group was com-bined with memantine, and the other group was combined with a placebo, with memantine 10 mg/d in the first week and 20 mg/d in the second week, for a 12-week course of treatment, and 60 cases were finally completed. Efficacy was assessed before treatment and at the end of the 4th, 8th and 12th week of treatment using the negative symptom scale (SANS) and the positive and negative symptom scale (PANSS), cognitive change using the brief mental status examination scale (MMSE) and safety using the treatment emergent symptoms scale (TESS). Results: The total SANS score, alogia subscale, attention deficit subscale and PANSS total score, and total PANSS negative factor score of the study group were all significantly lower than those of the control group at the end of the 12th week (P < 0.05 or P < 0.01); and the total SANS score, alogia subscale, attention deficit sub-scale, the total PANSS score, and total PANSS negative factor score of the study group were signifi-cantly lower from the end of the 8th week than before treatment (P < 0.05 or P < 0.01). MMSE scores were significantly higher in the study group than in the control group at the end of the 12th week (P < 0.05) and before treatment (P < 0.01) and the differences in adverse effects between the two groups were not statistically significant (P > 0.05). Conclusion: Memantine adjunctive therapy has a potentiating effect on the treatment of negative symptoms of schizophrenia with a good safety pro-file.