目的评价盐酸安非他酮缓释片治疗抑郁症的有效性和安全性,以及治疗该症伴随焦虑的疗效。方法共收集抑郁症患者211例,安非他酮组（治疗组）107例,氟西汀组（对比组）104例。采用多中心、随机、双盲双模拟、阳性药平行对照,剂量固定的研究。受试者分别口服安非他酮片300mg/d或氟西汀片20mg/d,疗程6周。结果治疗6周后,安非他酮组和氟西汀组的HAMD总分减分值分别为（11.75±6.66）、（11.91±5.43）（P=0.843）;有效率分别为69.2%、74.0%（P=0.432）;疾病严重度和总的进步评分（CGI）相比,P=0.295,0.245;治疗该症伴焦虑的HAMA总分减分评价疗效分别为（8.71±6.15）（、8.75±5.57）,P=0.952。以上结果提示各项指标的对比均无统计学差异。不良反应为主要为口干、头昏、恶心。结论盐酸安非他酮缓释片治疗抑郁症和/（或）伴随焦虑的疗效和安全性与盐酸氟西汀相似,认为其可作为一种安全有效的新型抗抑郁药物。

Objective To explore the relationship between cognitive impairments and duration of illness in patients with bipolar disorder at stationary phase.Methods 224 patients with bipolar I disorder at stationary phase were divided into 3 groups according to their duration: Group I(79 cases with duration ranged form 3 months to 1 year),Group Ⅱ(58 cases,1 year to 5 years) and Gruop Ⅲ(87 cases with duration above 5 years).The cognitive function were assessed with digital symbol,trail marking test(TMT),digital span,visual reproduction,Wisconsin Card Sorting Test(WCST),verbal fluency,Tower of Hanoi(TOH).Spearman correlation and partial correlation were used to analyze the correlation between cognitive impairments and duration of illness.Results Covariance analysis with the covariant as age showed that there were significant differences in number of replication of verbal fluency and number of mistake of TMT-B among the 3 groups(F=5.560,3.329 respectively;P=0.004,0.038 respectively),and the cognitive function of patients in Gruop Ⅲ was worse than those in Group I in both tests.Partial correlation analysis with controlled variable as age and education degree showed that only number of mistakes of TMT-B was significantly correlated with duration of illness(r=0.20,P<0.05),other 23 tests had no significant correlation with duration of illness(P>0.05).Conclusion The cognitive impairment in patients with bipolar disorder at stationary phase is stable.It may be one of the endophenotypes of bipolar disorder.

Objective To compare the use of new antipsychotic drugs (NAD) including Olanzapine, Risperidone and Qutipine in the treatment for children with schizophrenia. Methods 66 children patients were included in this study, according to the case disease condition history, we evaluated the efficacy and side effects with CGI and TESS before treatment, and at the 2nd,4th ,8th weeks after the treatment. Results The response rate of Risperidone, Olazapine and Qutipine are 71％, 85.7％, and 60％ respectively. The total response rate is 72.7％. The rates of side effects are 21％, 33％, 30％respectively. Conclusion It suggested that NAD is effective and safe in the treatment for children schizophrenia patients. NAD has been widely used in children schizophrenia outpatients.

目的:比较帕罗西汀与坦度螺酮治疗广泛性焦虑症的疗效及安全性。方法:将56例广泛性焦虑症的患者随机分为两组,分别给予帕罗西汀(20～40mg/d)和坦度螺酮(30～60mg/d)口服治疗,疗程6周,治疗前后采用汉密尔顿焦虑量表(HAMA)评定疗效,用抗抑郁药副反应评定量表(SERS)评定药物不良反应。结果:帕罗西汀、坦度螺酮两组治疗后HAMA分值较治疗前明显下降,差异均有统计学意义(P<0.05);治疗第1周末帕罗西汀组HAMA减分率高于坦度螺酮组(P<0.05),第2、4、6周末,两组间HAMA减分率差异无显著性(P>0.05);坦度螺酮组不良反应少于帕罗西汀组。结论:帕罗西汀和坦度螺酮均能有效治疗广泛性焦虑症,两者疗效相当;帕罗西汀起效快,坦度螺酮不良反应轻微。

目的 观察无抽搐电休克(MECT)合并艾司西酞普兰治疗难治性抑郁症(TRD)的临床疗效和安全性.方法 将60例难治性抑郁症患者随机分为MECT合并艾司西酞普兰组(治疗组)和单用艾司西酞普兰组(对照组),共观察4周.采用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)评定临床疗效,采用副反应量表(TESS)评定副反应.结果 治疗组在治疗第2、4周末HAMD、HAMA评分明显低于对照组,有统计学意义 (P＜0.05或P＜0.01);第4周末,两组显效率分别为66.7%、30.0%,有统计学意义(P＜0.01);两组TESS分值比较差异无统计学意义(P＞0.05),不良反应均轻微或一过性,患者耐受性好.结论 MECT合并艾司西酞普兰治疗难治性抑郁症优于单用艾司西酞普兰,具有起效快、疗效好、安全性高的特点,是目前治疗难治性抑郁症的优选治疗方法之一.

Objective To explore the status of job burnout and sleep problems in working population of psychiatric hospital.Mehtods 229 employees completed a battery of questionnaires,including Burnout Measure(BM),Athens Insomnia Scale(AIS-8) and Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS-30).Results Burnout and insomnia problems were found seriously in this population.BM:total score of 21 to 126,an average of 59.85±17.57;AIS:total score of 0 to 24,an average of 4.63±4.37;and DBAS:total score of 30 to 142,an average of 94.57±23.40.Scores of BM were significantly positively correlated with scores of AIS.Conclusion The results indicate that burnout and sleep problems were serious in working population of hospital,and significantly correlated with each other.Intervention on sleep problems might effectively alleviate burnout.

目的了解我院1996～2006年抗癫痫药的应用状况及变化趋势。方法采用WHO推荐的以DDD数为指标的药物利用研究方法,计算我院抗癫痫药的销售金额、用药频度、日用金额等指标并进行排序。结果我院抗癫痫药的销售金额和DDDs值大体上呈逐渐增长趋势。并且以传统抗癫痫药物为主,丙戊酸盐、卡马西平、苯妥英钠三种传统的抗癫痫药物临床使用频度约占95%。结论我们应该对药物的使用情况进行定期分析比较,为合理用药、开发新型抗癫痫药提供科学依据和思路。

目的 探讨安非他酮缓释片治疗抑郁症的临床疗效及安全性.方法 将72例抑郁症患者随机分为两组各36例,研究组口服安非他酮治疗,对照组口服氟西汀治疗,观察6 w.于治疗前及治疗1 w、2 w、4 w、6 w末采用汉密顿抑郁量表、汉密顿焦虑量表、临床总体印象量表、副反应量表评定临床疗效及不良反应.结果 研究组有效率83.3%,对照组为86.1%,两组有效率比较差异无显著性(P＞0.05).两组各量表评分,治疗1 w起均较治疗前有显著或极显著性下降(P＜0.05或0.01),2 w末起均有极显著性下降(P均＜0.01),但同期两组间比较差异无显著性(P均＞0.05).两组不良反应均较轻微,发生率比较无显著性差异.结论 盐酸安非他酮缓释片治疗抑郁症疗效与氟西汀相当,安全性高,依从性好.

目的 了解我院2003～2005年抗抑郁药的应用状况及变化趋势.方法采用WHO推荐的以DDD数为指标的药物利用研究方法,计算我院抗抑郁药的销售金额、用药频度、日用金额等指标并进行排序.结果抗抑郁药的销售金额和DDDs值逐年增长,年增长幅度分别为:2004年增长42.27%和24.29%,2005年增长8.78%和11.73%,且半数左右来自SSRIs类药物.新型抗抑郁药虽然日用药金额普遍较高,但由于其优点突出,已逐渐被临床所接受并广泛使用,经典的抗抑郁药因价格低廉等原因仍占有不小的市场份额.结论我们应该对药物的使用情况进行定期分析比较,为合理用药、科学管理及开发新产品提供科学依据和思路。

Objective To investigate the relationship between C734A polymorphism of CYP1A2 gene and Olanza-pine response in the treatment of schizophrenia. Methods 113 patients with schizophrenia were received 8-week Olanzapine treatment. Efficacy was evaluated by the Positive and Negative Syndrome Scale, and biochemical measures were collected at baseline and at the end of the 8-week. Genotypes were analyzed by PCR-RFLP techniques. Results Patients were divided into responder group (69) and non-responder group (44) by threshold of 50% baseline-endpoint decrease rate in PANSS score, frequencies of genotype and alleles of C734A polymorphism of CYP1A2 gene were not significantly different between the two groups. While no significant differences in decreases or decrease rates in PANSS score, positive symptom score and negative symptom score were found between different genotype groups. A multiple linear regression analysis showed genotype of CYP1A2 gene had not significant effect on decrease rates in PANSS score, positive symptom score or negative symptom score. In addition, confounding effects of duration of illness, initial PANSS score and dose on change in above clinical response indexes could not be detected. Differences of increases after treatment in glucose, triglyceride, cholesterol and weight were not significant between genotype groups. Conclusions CYP1A2 gene was not associated with response to Olanzapine treatment and its induced-change in glucose, three-glycerol, cholesterol and weight.

Objective To compare efficacy and safety of olazepine and risperdone in the treatment offirst episode schizephrenia.Methods 64 patients with schizophrenia by CCMD-3 were randomly allocatedto two groups with olazepine or risperdal for 8 weeks. The Positive and Negative Syndrom Scale (PANSS),BPRS,CGI and Treatment Emergent Symptoms Scale (TESS) were used to evaluate efficacy and adverse effectsrespectively before and ends of 1,2,4,8weeks of treament. Results The total effective rares for theolazepine and risperdal groups were 83.87% and 81.48% respectively after 8weeks .There was no significantdifference between the two groups (P0.05).Incidence of adverse effects were 37.50% and 59.38%,there wasno significant difference between the two groups (P0.05).Conclusions The results suggest thatolazepine is as risperdone for the theatment of first episode schizophrenia. But two agents havedifferent of side effects profile.

目的 探讨富马酸奎的平治疗精神分裂症的临床疗效及安全性,并与盐酸氯丙嗪进行比较.方法 96例符合中国精神障碍分类与诊断标准(CCMD-3)的精神分裂症患者被随机分为两组,分别给予奎的平和氯丙嗪治疗6周,以阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)进行疗效评定,以不良反应量表(TESS)、实验室检查和生命体征进行副作用评定.结果共88例完成试验,研究组(46例)总有效率为60.87%,对照组(42例)为61.90%,两组间差异均无显著性;研究组总的不良反应发生率为25.00%,对照组为66.67%,差异有显著性(P<0.01).结论富马酸奎的平治疗精神分裂症的疗效与氯丙嗪相当,不良反应发生率明显较低。

目的探讨首发精神分裂症患者发病对配偶情绪的影响及其配偶的社会支持状况.方法我们采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及社会支持量表(SS)对132例精神分裂症患者的配偶进行调查.结果132例配偶的SDS和SAS得分分别为(41.76±6.93)分和(34.48±6.70)分,均明显高于国家常模(P＜0.01);男患者配偶的SDS和SAS得分均显著高于女患者配偶(P＜0.01);相关分析结果,抑郁和焦虑得分与社会支持总分、客观支持及利用度均呈负相关.结论精神分裂症发病可导致患者配偶明显的抑郁和焦虑状态(尤以男患者配偶明显);患者配偶的社会支持不足可加重其负性情绪,并建议给予其适当的支持性心理辅导.

目的:评价乐忧坦治疗抑郁症的临床疗效与安全性. 方法:对60例抑郁症患者随机分为两组,分别给予乐忧坦或氟西汀治疗6周,采用汉密顿抑郁量表(HAMD),汉密顿焦虑量表(HAMA),临床疗效总评量表(CGI)评定疗效,用副反应量表(TESS)评定不良反应. 结果:58例患者完成治疗,乐忧坦组有效率为89.29%与氟西汀组比较差异无显著性;不良反应少而轻,安全性好. 结论:乐忧坦是一种有效的抗抑郁药.

目的:评价氯丙嗪合并低剂量的奥氮平治疗难治性精神分裂症患者的疗效、安全性与经济学指标.方法:对经氯丙嗪系统治疗无效的39例精神分裂症患者随机分组,分别采用氯丙嗪合并奥氮平2.5～5mg/d与单用奥氮平进行为期8周的治疗,采用阳性与阴性症状量表(PANSS)、简明精神病评定量表(BPRS)、临床总体印象量表(CGI-S)进行疗效评定,用不自主运动量表(AIMS)、Simpson-Angus量表(SAS)、TESS评定其不良反应,并记录每日治疗药物费用.结果:氯丙嗪合并奥氮平治疗组与单用奥氮平组治疗前后BPRS减分率分别是51.7%与55.1%,有效率分别为50.0%与57.1%,两组未见显著性差异(P＞0.05),安全性好,合并治疗组的平均每日药费(18.50±8.45元)明显低于奥氮平组(87.25±23.83元/d)(P＜0.001).结论:氯丙嗪合并低剂量的奥氮平是治疗难治性精神分裂症有效安全经济的方法之一.

目的探讨再普乐快速镇静疗法的临床疗效与安全性.方法随机选取具有明显兴奋症状的分裂症患者11例和躁狂症患者1例,给予再普乐(15～25 mg/d)快速镇静治疗2周.以治疗前后简明精神病量表(BPRS)激越分的减分率评定疗效,以不良反应量表评定安全性.结果1周后10例有效,2例无效,有效率83.3%.2周后11例有效,1例脱落,有效率91.7%.病人有体重增加等轻度副反应.结论再普乐快速疗法疗效肯定,病人耐受性良好.

目的:探讨抗抑郁药在强迫症治疗中引起躁狂发作的情况. 方法: 回顾性分析近10年中83例强迫症住院患者的临床资料. 结果:治疗强迫症引起躁狂的发生率为19.28%,各种抗抑郁药均可引起.联合小剂量抗精神病药可降低其发生率. 结论:抗抑郁药物治疗强迫症可引起躁狂发作,其机制尚不清楚.