摘要

【摘要】
目的：探讨不同剂量托吡酯联合喹硫平治疗精神分裂症的临床疗效及对血清神经损伤因子的影响。

方法：选取2022年12月至2024年10月医院精神分裂症患者96例。按随机数字表法分为对照组（喹硫平单用，n=32）、低剂量组（托吡酯100 mg/d联合喹硫平，n=32）和高剂量组（托吡酯200 mg/d联合喹硫平，n=32），疗程均为8周。比较三组阳性与阴性症状量表（PANSS）、中国简版神经认知成套测验（C-BCT）评分，检测血清神经元特异性烯醇化酶（NSE）与S100B蛋白水平变化，并记录不良反应。

结果：高剂量组治疗后总有效率高于低剂量组、对照组（P＜0.05）。三组PANSS总分及各分量表评分较治疗前均显著降低（P<0.05），且高剂量组改善幅度优于低剂量组和对照组（P<0.05）。三组治疗后血清NSE、S100B水平下降，且高剂量组更低（P<0.05）。治疗后，高剂量组C-BCT各维度评分高于低剂量组和对照组（P<0.05）。三组不良反应总发生率差异无统计学意义（P>0.05）。

结论：托吡酯联合喹硫平治疗精神分裂症具有良好疗效，其中高剂量托吡酯可显著改善精神症状，降低血清NSE、S100B水平，安全性较好。

关键词：【关键词】托吡酯；喹硫平；精神分裂症；神经元特异性烯醇化酶；S100B

ABSTRACT

【Abstract】
Objective: To investigate the clinical efficacy of different doses of topiramate combined with quetiapine in treating schizophrenia and its effects on serum neurotrauma factors.

Methods: A total of 96 patients with schizophrenia admitted to our hospital from December 2022 to October 2024 were enrolled. Participants were randomly assigned using a random number table to the control group (quetiapine monotherapy, n=32), low-dose group (topiramate 100 mg/day combined with quetiapine, n=32), and high-dose group (topiramate 200 mg/day combined with quetiapine, n=32). All groups underwent a 8-weeks treatment course. Compare the scores of the positive and negative symptom scale (PANSS) and Chinese short version neurocognitive test (C-BCT) among three groups. Changes in serum neuron-specific enolase (NSE) and S100B levels were measured, and adverse reaction rates were recorded.

Results: A significantly higher overall response rate was observed in the high-dose group compared to the low-dose and control groups (P<0.05). All groups showed significant reductions in PANSS total scores and subscale scores compared to baseline (P<0.05), with greater improvement in the high-dose group than in the low-dose and control groups (P<0.05). Serum NSE and S100B levels in all groups decreased after treatment, and even lower in the high-dose group (P<0.05). After treatment, the scores of each dimension of C-BCT in the high-dose group were higher than those in the low-dose group and control group (P<0.05). Comparison of the three groups revealed no statistically significant differences in the overall incidence of adverse reactions (P>0.05).

Conclusion  : The combination of topiramate and quetiapine demonstrates favourable efficacy in treating schizophrenia. High-dose topiramate has been demonstrated to significantly improve psychotic symptoms, reduce the levels of serum NSE and S100B, and exhibit a favourable safety profile.

Key words: 【Keywords】Topiramate; Quetiapine; Schizophrenia; Neuron-specific enolase; S100B