目的 分析国产帕利哌酮缓释片治疗稳定期精神分裂症的疗效与安全性。方法 采用随机数字表法将驻马店市第二人民医院2021年10月—2023年10月收治的108例稳定期精神分裂症患者分为对照组（服用原研帕利哌酮缓释片）与观察组（服用国产帕利哌酮缓释片）,每组各54例,以阳性与阴性症状量表（PANSS）评分变化为疗效衡量指标,以不良反应发生率及药物副反应量表（TESS）评分变化为安全性衡量指标。结果 治疗后,两组PANSS评分均比治疗前降低,组内不同时间点评分差异有统计学意义（t=22.147、4.513、3.431、21.369、3.927、3.601,P值分别为<0.001、<0.001、0.001、<0.001、<0.001、<0.001）,但组间不同时间点评分比较差异无统计学意义（t=0.281、0.043、0.150,P=0.779、0.966、0.881）;观察组不良反应发生率（14.81%）与对照组（12.96%）比较差异无统计学意义（χ²=0.090,P=0.765）;两组TESS评分接近,不良反应皆轻微（t=0.185,P=0.856）。结论 国产帕利哌酮缓释片治疗稳定期精神分裂症患者可促进症状改善,且不良反应轻微,疗效及安全性与原研制剂相当。

Objective To analyze the efficacy and safety of domestic paliperidone sustained-release tablets in the treatment of stable schizophrenia．Methods A total of 108 patients with stable schizophrenia admitted to Zhumadian Second People's Hospital from October 2021 to October 2023 were divided into control group（taking the original paliperidone sustained-release tablet）and observation group（taking domestic paliperidone sustained-release tablet）by random number table method,with 54 cases in each group．The change of Positive and Negative Symptom Scale（PANSS）was used as the efficacy measure,and the change of incidence of adverse reactions and Treatment Emergent Symptom Scale（TESS） score was used as the safety measure．Results After treatment,PANSS scores in both groups were lower than before treatment,and the differences in scores at different time points in the groups were statistically significant（t=22.147,4.513,3.431,21.369,3.927,3.601,the P values were<0.001,<0.001,0.001,<0.001,<0.001,<0.001,respectively）．However,there was no significant difference in scores at different time points between the groups（t=0.281,0.043,0.150,P=0.779,0.966,0.881）．There was no significant difference in the incidence of adverse reactions between observation group（14.81%）and control group（12.96%）（χ²=0.090,P=0.765）．TESS scores were similar between the two groups,and adverse reactions were mild（t=0.185,P=0.856）．Conclusions The domestic paliperidone sustained-release tablets can improve the symptoms of stable schizophrenia patients,and the side effects are slight,and the efficacy and safety are comparable to the original agent．

目的 针对精神分裂症患者接受喹硫平与帕利哌酮联合治疗对其代谢功能及血清因子的影响。方法 纳入2022年1月—2023年3月驻马店市第二人民医院收治的120例精神分裂症患者,根据住院号进行编号,并通过通过随机抽签方法分为两组,对照组60例应用单一喹硫平治疗,观察组60例应用喹硫平与帕利哌酮联合治疗,对比两组的治疗效果。结果 经治疗,观察组临床总疗效高于对照组（P<0.05）;该组各项代谢功能指标均与对照组比较差异无统计学意义（P>0.05）;该组各项血清因子测定该结果均高于对照组（P<0.05）;该组各项精神症状评分均低于对照组（P<0.05）;该组不良反应发生率与对照组比较差异无统计学意义（P>0.05）。结论 采用喹硫平与帕利哌酮联合的方式治疗精神分裂症患者,可以提升临床疗效,对患者各种精神症状及血清因子改善效果更好,虽然药物会对患者代谢功能产生一定的影响,但是联合用药与单独用药的影响情况无差异,未增加不良反应发生率,安全性良好。

Objective To evaluate the combination of quetiapine and paliperidone on metabolic function and serum factors in schizophrenia．Methods A total of 120 patients with schizophrenia admitted to Zhumadian Second People's Hospital from January 2022 to March 2023 were included,numbered according to the hospitalization number,and divided into two groups by random drawing method．Sixty patients in the control group were treated with quetiapine alone,and 60 patients in the observation group were treated with quetiapine combined with paliperidone,and the therapeutic effects of the two groups were compared．Results After treatment,the total clinical efficacy of the observation group was higher than that of the control group,P<0.05;the metabolic function indexes comparison were P> 0.05;the serum factor of observation group was higher,P<0.05;the scores of psychiatric symptoms in the group were all lower than the control group,P<0.05;the incidence of adverse reactions in the observation improve group was not different from the control group,P>0.05．Conclusions Using quetiapine and schizophrenia,can improve clinical curative effect,various mental symptoms and serum factors,although certain effect on patient metabolic function may occur,but did not significantly increase the incidence of adverse reactions,with high safety．

目的 分析精神分裂症患者体内的肌酸激酶（CK）、肌红蛋白（MYO）、β₂微球蛋白（β₂-MG）、细胞间黏附分子（ICAM）水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤（AKI）可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组（同期我院门诊健康体检者）20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β₂-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β₂-MG值高于健康对照组及肾功能正常组,差异具有统计学意义（F=623.534,30.437,636.776,88.283,P<0.05）,精神分裂症AKI 1期组到AKI 3期组CK、MYO、β₂-MG、ICAM数值均比对照组升高（P<0.05）,3组之间如上指标的比较差异有统计学意义（P<0.05）。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β₂-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。

Objective To study the changes of serum creatine kinase（CK）,myoglobin（MYO）,β₂ microglobulin（β₂-MG）,intercellular adhersion molecule（ICAM）with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury（AKI）in patients with schizophrenia．Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls（who underwent physical examination during the same period）were included．At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β₂-MG level in each group．The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed．Results The serum CK,MYO,ICAM and β₂-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant（F=623.534,30.437,636.776,88.283,P<0.05）,and the comparison of the above indexes among the three groups was statistically significant（P<0.05）．Conclusions The abnormal increase of serum CK,MYO,ICAM and β₂-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis．

目的 探讨精神分裂症患者载脂蛋白E基因多态性与血清ApoE浓度、血脂、心血管疾病发生风险的相关性。方法 收集住院精神分裂症患者116例,记录一般资料和测定患者载脂蛋白E基因(APOE)、载脂蛋白E(ApoE)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、心血管疾病发生风险评分(Framingham risk score,FRS)等指标。结果 ①APOEε2、ε3、ε4不同等位基因组精神分裂症患者TC、载脂蛋白E、FRS评分差异有统计学意义(P=0.01,P=0.005,P=0.012)。②载脂蛋白E与TC、FRS评分存在负相关关系(r_s=-0.48,P=0.02;r_s=-0.52,P=0.04),APOE ε4等位基因组载脂蛋白E与TC、FRS评分存在更高的相关关系(r_s=-0.55,P<0.001;r_s=-0.63,P=0.04)。结论 精神分裂症患者ApoE基因多态性与载脂蛋白E、胆固醇、FRS评分存在关联,ApoE基因-载脂蛋白E-胆固醇代谢通路可能是精神分裂症患者心血管疾病的致病机制之一。

目的 探讨改良型音乐治疗对慢性精神分裂症患者临床康复效果的影响。方法 选取2010年4月—10月在我院住院的病情稳定的慢性精神分裂症患者76例,随机分为研究组和对照组各38例,两组患者在同等环境下维持原来的药物治疗和护理,研究组同时予以改良型音乐治疗,观察6个月,采用护士用住院病人观察量表(NOSIE)对两组进行评估。结果 两组经过治疗后,NOSIE各项因子分均较前有明显提高,差异有统计学意义;研究组 NOSIE总积极分、社会能力、社会兴趣、个人整洁等得分较对照组有明显提高,差异有统计学意义;总消极分激惹、精神病表现、迟缓、抑郁较对照组有较明显降低,差异统计学意义。结论 改良型音乐治疗,对慢性精神分裂症患者的临床康复有积极的促进作用。

Objective To explore the effect of modified music therapy on the rehabilitation of patients with chronic schizophrenia. Methods 76 patients with chronic schizophrenia who were hospitalized in our hospital from October to April of 2010 were randomly divided into study group and control group (38 cases). The patients in the two groups were treated with the same environment. The research group was treated with modified music. The two groups were evaluated by using the observation scale (NOSIE). Results Two groups after treatment, the NOSIE of the factors were significantly improved, the difference was statistically significant; the study group NOSIE total score, social ability, social interest, personal cleanliness, etc, compared with the control group were significantly improved. The difference was statistically significant; the total negative score, mental disease, depression, and the control group were significantly lower than the control group, the difference was statistically significant. Conclusion Modified music therapy has a positive effect on the rehabilitation of patients with chronic schizophrenia.

目的 探索协助式农疗对慢性精神分裂症患者社会功能的影响。方法 选取住院5年以上的慢性精神分裂症患者64例,随机分为研究组32例和对照组32例,实施室外农艺园艺方面的职业康复训练,并实行协助式管理新模式,康复训练前与训练后的第1、3、6月末分别采用护士用住院病人观察量表(NOSIE)对患者进行评价。结果 患者通过协助式农疗后,NOSIE总积极分、社会能力、社会兴趣、个人整洁等得分有明显提高,有统计学意义;总消极分激惹、精神病表现、迟缓、抑郁出现降低,有统计学意义。结论 慢性精神病患者在工作人员协助下参加农艺和园艺技术培训治疗,其症状和社会功能有较显著的改善。

Objective To explore the impact of assisted farming and gardening therapy on social function of patients with chronic schizophrenia. Methods 64 patients with chronic schizophrenia were randomly and equally divided into research group and control group, with 32 cases implemented outdoor farming and gardening vocational rehabilitation training in new management mode. Observe scale evaluation (NOSIE) was applied to assess the patients at the time before the training, one month after the training, three month after the training, and six month after the training. Results Patients received assisted farming therapy scored higher in total positive points, social ability, social interest, individual tidy. The difference was statistically significant. The scores of total negative points irritability, mental performance, slow, depression had reduced with statistical significance. Conclusion Assisted farming and gardening therapy can relieve patients' symptoms and improve patients' function.

        目的   比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效，以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法   连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例，采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d，阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前（基线）以及连续用药治疗2、4、6周后的PANSS量表评分，以及治疗后的代谢指标［体质量指数（BMI）、血清空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE），并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果   两组的总有效率比较差异无统计学意义（χ ² =1.569，P＞0.05）；两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义（χ ² =0.466、3.640，P=0.926、0.056），时间主效应显著（χ ² =363.24，P＜0.001）。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应（χ ² =7.562、5.991、6.163、6.958、4.397，P=0.006、0.014、0.013、0.008、0.036），两组TG、ApoA时间主效应显著（χ ² =33.473、8.846，P＜0.001、0.003），两组ApoA组别效应显著（χ ² =4.889，P=0.027）。结论   与奥氮平相比，鲁拉西酮治疗女性急性期精神分裂症的疗效相当，且对代谢指标影响更小。

        Objective  To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia，as well as their effects on body mass，glucose and lipid metabolism risk．To provide  reference for the selection of antipsychotic drugs for female patients with acute schizophrenia．Methods  From April 2022 to April 2024，80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study．The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison．The treatment group took oral lorazepine tablets（40 cases；40-80 mg/d），while the positive drug control group took oral olanzapine tablets（40 cases；5-20 mg/d）．The Positive and Negative Symptom Scale（PANSS）scores of two groups before treatment（baseline）and after 2，4，and 6 weeks of continuous medication treatment were measured，as well as metabolic indicators after treatment （body mass index［BMI］，serum fasting blood glucose［FPG］，total cholesterol［TC］，triglycerides［TG］，high-density lipoprotein［HDL］，low-density lipoprotein［LDL］，apolipoprotein A［ApoA］，apolipoprotein B［ApoB］，apolipoprotein E［ApoE］），and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed．Results  The total effective  rate of the two groups was not statistically significant（χ ² =1.569，P＞0.05）．The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant（χ ² =0.466，3.640，P=0.926，0.056），while the time main effect was significant（χ ² =363.24，P＜0.001）．There was a group-time interaction effect between two groups of TG，TC，HDL，ApoA，and ApoB（χ ² =7.562，5.991，6.163，6.958，4.397，P=0.006，0.014，0.013，0.008，0.036）．The time main effect of TG and ApoA was significant in both groups（χ ² =33.473，8.846，P＜0.001，0.003），and the group effect of ApoA was significant in both groups（χ ² =4.889，P=0.027）．Conclusions  Compared with olanzapine，the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable，and it has a smaller impact on metabolic indicators．