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目的:探讨奥卡西平联合齐拉西酮治疗精神分裂症患者急性期兴奋激越的临床效果。方法:选择2016年1月至2019年1月衢州市第三医院收治的精神分裂症急性期兴奋激越患者110例进行研究,采用随机数字表法分为观察组和对照组,每组55例。对照组给予齐拉西酮胶囊治疗,观察组给予奥卡西平联合齐拉西酮胶囊治疗,治疗4周。比较两组治疗前后的PANSS兴奋激越因子(PANSS-EC)、外显攻击行为量表(MOAS)、临床疗效总评量表病情严重程度(CGI-SI)评分、血清神经细胞因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、胶质源性神经营养因子(GDNF)]、同型半胱氨酸(Hcy)、炎性因子[白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素12(IL-12)、肿瘤坏死因子α(TNF-α)]变化情况,以及不良反应发生率。结果:治疗后,两组的PANSS-EC、MOAS、CGI-SI评分、Hcy、IL-1β、TNF-α水平均降低(n t=7.829、14.952、3.417、15.511、18.948、7.193、18.453、24.161、1.995、3.378、3.968、6.820,均n P<0.05),且观察组均低于对照组[(15.34±3.56)分比(11.08±3.17)分、(5.36±1.68)分比(4.15±1.46)分、(5.56±1.21)分比(4.18±1.35)分、(14.29±2.42)μmol/L比(10.63±2.24)μmol/L、(48.15±15.63)ng/L比(42.18±10.51)ng/L、(29.57±8.76)ng/L比(23.48±6.76)ng/L](n t=6.628、4.032、5.645、8.231、2.351、4.082,均n P<0.05),而BDNF、NGF、GDNF水平均升高(n t=6.253、6.346、3.513、13.906、15.874、7.507,均n P<0.05),且观察组均高于对照组[(9.34±1.23)μg/L比(11.35±1.34)μg/L、(21.37±2.85)μg/L比(26.87±3.21)μg/L、(439.51±56.42)ng/L比(489.63±58.15)ng/L],差异均有统计学意义(n t=2.351、3.523、3.204,均n P<0.05);两组不良反应发生率差异无统计学意义[25.45%(14/55)比12.73%(7/55),χn 2=2.884,n P=0.089]。n 结论:奥卡西平联合齐拉西酮可有效控制精神分裂症急性期兴奋激越的临床症状,改善血清的细胞因子、Hcy及炎性因子水平,且安全性高。“,”Objective:To investigate the clinical effect of oxcarbazepine combined with ziprasidone in the treatment of acute excitatory agitation in patients with schizophrenia.Methods:From January 2016 to January 2019, a total of 110 patients with acute excitatory schizophrenia who admitted in the Third Hospital of Quzhou were enrolled, and they were divided into observation group and control group according to the random digital table method, with 55 cases in each group.The control group was given ziprasidone capsule, and the observation group was given oxcarbazepine combined with ziprasidone capsule treatment for 4 weeks.The PANSS excitatory agitation factor(PANSS-EC), explicit aggressive behavior scale(MOAS), clinical efficacy rating scale(CGI-SI) score, serum neurocytokines[brain-derived nutritional factors(BDNF), nerve growth factor(NGF), glial-derived neurotrophic factor(GDNF)], homocysteine (Hcy), inflammatory factors[interleukin 1β(IL-1β), interleukin 6(IL-6), interleukin 12(IL-12), tumor necrosis factor α(TNF-α)] before and after treatment and the incidence of adverse reactions were compared between the two groups.Results:After treatment, the PANSS-EC, MOAS, CGI-SI scores, Hcy, IL-1β and TNF-α levels were decreased in the two groups(n t=7.829, 14.952, 3.417, 15.511, 18.948, 7.193, 18.453, 24.161, 1.995, 3.378, 3.968, 6.820, all n P<0.05), which of the observation group were lower than those of the control group[(15.34±3.56)points vs.(11.08±3.17)points, (5.36±1.68)points vs.(4.15±1.46)points, (5.56±1.21)points vs.(4.18±1.35)points, (14.29±2.42)μmol/L vs.(10.63±2.24)μmol/L, (48.15±15.63)ng/L vs.(42.18±10.51)ng/L, (29.57±8.76)ng/L vs.(23.48±6.76)ng/L](n t=6.628, 4.032, 5.645, 8.231, 2.351, 4.082, all n P<0.05), while the BDNF, NGF, GDNF levels were increased(n t=6.253, 6.346, 3.513, 13.906, 15.874, 7.507, all n P<0.05), which of the observation group were higher than those of the control group[(9.34±1.23)μg/L vs.(11.35±1.34)μg/L, (21.37±2.85)μg/L vs.(26.87±3.21)μg/L, (439.51±56.42)ng/L vs.(489.63±58.15)ng/L], the differences were statistically significant(n t=2.351, 3.523, 3.204, all n P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups[25.45%(14/55) vs.12.73%(7/55), χn 2=2.884, n P=0.089].n Conclusion:Oxcarbazepine combined with ziprasidone in the treatment of acute excitatory patients with schizophrenia can control the clinical symptoms, improve the serum levels of cytokines, Hcy and inflammatory factors, and has high safety.