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目的 探讨奥氮平联合丙戊酸钠缓释片治疗伴攻击行为精神分裂症患者的临床疗效及对认知功能的影响.方法 将80例伴攻击行为的精神分裂症患者按照随机数字表法分为观察组与对照组,各40例.两组均给予奥氮平治疗,观察组联合丙戊酸钠缓释片治疗,观察10周.于治疗前及治疗第1周、2周、4周、8周末采用阳性与阴性症状量表和外显攻击行为量表评定临床疗效,采用韦氏成人智力量表评估学习、记忆功能,威斯康星卡片分类测验评估执行功能.结果 治疗8周末,两组阳性与阴性症状量表总评分及各分量表评分均显著低于治疗前,观察组各项评分均显著低于对照组(P＜0.05或0.01).治疗后2周末起两组外显攻击行为量表评分均显著低于治疗前(P＜0.05或0.01),观察组较对照组下降更显著(P＜0.01).治疗后观察组言语流畅及威斯康星卡片分类测验完成分类数、韦氏成人智力量表顺背数、图片及再认评分均显著高于治疗前(P＜0.05或0.01),威斯康星卡片分类测验持续错误数显著低于治疗前(P＜0.05),对照组完成分类数评分显著高于治疗前(P＜0.05),观察组评分较对照组变化更显著(P＜0.05或0.01).结论 奥氮平联合丙戊酸钠缓释片治疗伴攻击行为精神分裂症患者起效快,能显著改善患者的精神症状和认知功能,改善攻击行为.“,”Objective To investigate the clinical effect of olanzapine combined with compound sodium in the treatment of schizophrenia with aggression and influence on cognitive function. Method 80 cases with schizophrenia with aggression were randomly divided into the observation group and the control group, 40 cases in each group. The two groups were all given olanzapine treatment, and the observation group was given olanzapine combined with compound sodium treatment, patients were observed for 10 weeks. PAN-SS,MOAS,WAIS and WCST were used to evaluate the clinical effects, learning and memory functions, executive functions of patients before treatment and at the end of 1, 2,4, 8 weeks after treatment. Results At the end of 8 weeks after treatment, PANSS total scores and scale scores of the two groups were all significantly lower than those before treatment, all scores in the observation group were significantly lower than those in the control group (P＜0.05 or 0.01). At the end of 2 weeks after treatment, MOAS scores of the two groups were all significantly lower than those before treatment (P＜0.05 or 0.01),observation group declined more significantly than the control group (P＜0.01). Verbal fluence, WCST CC,WAIS sequential recitation numbers, WAIS pictures, WAIS recognition scores in the observation group were significantly higher than those in the control group after treatment (P＜0.05 or 0.01),WCST PE was significantly lower than that before treatment (P ＜0.05), WCST CC in the control group was significantly higher than that before treatment (P＜0.05),scores of the observation group changed more significantly than those of the control group (P＜0.05 or 0.01). Conclusion Olanzapine combined with compound sodium take effect quickly in the treatment of schizophrenia with aggression, it can significantly improve mental symptom, cognitive function and aggressive behaviour of patients.