偏执型精神分裂症伴非自杀性自身攻击患者联合治疗方案的比较分析及对持续抗精神病药单一治疗的抗性迹象

Kravchenko I.V.
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引用次数: 0

摘要

对患有NSAA的偏执型精神分裂症患者进行了联合治疗方案的比较分析,并确定了对持续的抗精神病药单一治疗的抵抗迹象。在2015年至2022年期间,155例偏执型精神分裂症合并NSAA患者作为多中心随机纵向研究的一部分进行了研究。已经确定这组患者的一线治疗方案是氯氮平与氟哌啶醇的联合治疗方案。介绍。偏执型精神分裂症伴自身攻击的治疗抵抗患者数量的增加仍然是精神病学中最常见的疾病单元之一[1,2,3]。同时,对于影响该类患者耐药状态形成的因素和条件也积累了大量的研究资料[4,5,6,7]。首先,这些包括:幼年出道、“被抹去”的开端、持续的过程、病理过程结构中阴性症状的主导地位,以及情感成分的消退。在治疗抵抗的临床预测因子中,具有自我攻击倾向的精神疾病占据了一个特殊的位置,传统上被认为是在heboid状态的框架内。与此同时,直到最近,用于克服耐药的抗精神病药组中的主要药物是氯氮平[8,9,10,11,12,13]。在实践中,高达30%的患者对其作用完好无损,这表明需要联合治疗[14,15,16]。这预先决定了为解决这一问题而寻找新的药物使用方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Analysis of Combination Therapy Regimens in Patients with Paranoid Schizophrenia with Non-Suicidal Auto aggression and Identified Signs of Resistance to Ongoing Neuroleptic Monotherapy
A comparative analysis of combination therapy regimens was carried out in patients with paranoid schizophrenia with NSAA and identified signs of resistance to ongoing neuroleptic monotherapy. In total, in the period from 2015 to 2022, 155 patients with paranoid schizophrenia with NSAA were studied as part of a multicenter randomized longitudinal study. It has been established that the first-line therapy regimen in this group of patients is a combined regimen of clozapine with haloperidol. Introduction. The increase in the number of therapeutically resistant patients with paranoid schizophrenia with auto aggression remains one of the most pressing problems in psychiatry remains as the most common nosological unit [1,2,3]. At the same time, a large amount of research material has been accumulated on the factors and conditions that affect the formation of the state of resistance in such patients [4,5,6,7]. First of all, these include: a debut at an early age, an "erased" beginning, a continuous course, the dominance of negative symptoms in the structure of the pathological process, and the fading of the affective component. A special place among the clinical predictors of therapeutic resistance is occupied by psychopathic disorders with auto aggressive tendencies, traditionally considered within the framework of heboid states. At the same time, until recently, the main drug from the group of neuroleptics used to overcome resistance was clozapine [8,9,10,11,12,13]. In practice, up to 30% of patients remain intact to its action, which dictates the need for combination therapy [14,15,16]. This predetermines the search for new schemes for the use of medicinal drugs to solve this problem.
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