Effects of paliperidone combined with dexzopiclone in the treatment of schizophrenia with sleep disorders and on neurological function,sleep quality,serum PRL and CRP
Objective To explore the efficacy of paliperidone combined with dexzopiclone in the treat-ment of schizophrenia with sleep disorders and its effects on neurological function,sleep quality,serum prolactin(PRL)and C-reactive protein(CRP).Methods A total of 92 patients with schizophrenia and sleep disorders ad-mitted to Lishui Second People's Hospital from July 2021 to December 2023 were selected as the study subjects.They were divided into a combination group(n=46)and a control group(n=46),according to different treatment methods.The control group was treated with paliperidone combined with lorazepam while the combined group were given paliperidone combined with dexzopiclone.Before the treatment and after 4 weeks,8 weeks and 12 weeks of the treatment,evaluate the changes of these symptoms:the schizophrenic symptoms[Positive and Nega-tive Syndrome Scale(PANSS)],neurological function[Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],brain neurotrophic indicators[brain-derived neurotrophic factor(BDNF),neurotrophin-3(NT-3),dopamine(DA),5-hydroxytryptamine(5-HT)],levels of serum PRL and CRP.The adverse reactions during treatment were counted.Results After 4 weeks,8 weeks and 12 weeks of the treatment,the PANSS scores of the two groups were gradually decreased,and there was a statisti-cal difference at different time points within the same group(P＜0.05).The scores after 4 weeks,8 weeks and 12 weeks of the treatment in the combination group[(46±5)points,(40±4)points,and(32±4)points]were significant-ly lower than those in the control group[(48±5)points,(42±4)points,and(34±4)points](P＜0.05).After 12 weeks of the treatment,the MoCA and MMSE scores of both groups of patients significantly decreased(P＜0.05),and the scores in the combination group[MoCA(12.5±1.5);MMSE(12.1±1.0)]were significantly lower than those in the control group[MoCA(18.2±2.0);MMSE(17.6±1.6)](P＜0.05).After 12 weeks of treatment,the PSQI scores of both groups of patients significantly decreased(P＜0.05),and the sleep quality,sleep time,time falling into sleep,sleep efficiency,sleep disorders,daytime function in the combined group[0.85±0.12;0.98±0.24;0.97±0.18;0.86±0.14;0.88±0.07;0.79±0.18 was significantly lower than those in the control group[sleep quality[(1.02±0.47)sleep time;(1.04±0.34)time falling into sleep(1.05±0.38);sleep efficiency(1.03±0.56);sleep disorders(1.01±0.41);daytime function(1.01±0.57)](P＜0.05).After 12 weeks of treatment,the levels of serum BDNF,NT-3,DA and 5-HT in the two groups were higher than those before treatment(P＜0.05),and the levels in combination group(4 715±138 ng/ml,179±18 ng/ml,71±7 ng/ml,44±7 ng/ml)were significantly higher compared with those in the control group(4 218±162 ng/ml,150±16 ng/ml,61±6 ng/ml,36±5 ng/ml)(P＜0.05).After 12 weeks of the treat-ment,the levels of serum PRL and CRP in both groups were higher than those before the treatment(P＜0.05).There was no significant difference in PRL between the two groups[combination group(64±11)ng/ml;control group(67±10)ng/ml](P＞0.05),but the level of CRP in the combined group was lower than that in the control group(53±6)mg/L vs(56±6)mg/L,P＜0.05].The total incidence rate of in the combination group(8％)was signifi-cantly lower than that in the control group(26％)(P＜0.05).Conclusion Compared to the combination of paliperidone and lorazepam,the combination of paliperidone and dexzopiclone can better alleviate the severity of schizophrenia in patients with sleep disorders,improve their sleep disorders,and increase brain neurotrophic fac-tor levels.It is worth applying.
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