| Objective: Schizophrenia is a serious mental disease whose etiology is not yet clear.Among all kinds of mental diseases,schizophrenia has a long course of illness and its condition is prolonged and repeated,which seriously affects the patients’ life,work and interpersonal skills.Characteristics of schizophrenia: most of patients with schizophrenia in late adolescence or early adulthood have disease,primary auditory hallucination and delusion is the typical symptoms of schizophrenia,and diagnostic significance,at the same time,the disease seriously affect the patient’s psychological,cognitive and social functions,such as overall performance for the patient’s cognition,emotion and meaning.The treatment of schizophrenia has always been a historical problem,schizophrenia patients still face the harsh reality of lifelong medication,for the treatment of schizophrenia,gradually from the typical antipsychotics to atypical antipsychotics,effectiveness and the atypical antipsychotics have got a lot of research results.However,although this major transformation has significantly avoided the common adverse reactions of typical antipsychotics such as extrapyramidal reactions,atypical antipsychotics have also resulted in hyperprolactinemia and various influences on the endocrine system,such as irregular menstruation,amenorrhea and infertility.The effects of hyperprolactinemia and endocrine dysfunction on the long-term prognosis of patients were significant.Amisulpride is a new and effective atypical antipsychotic commonly used by psychiatrists.Compared with other atypical antipsychotics,amisulpride appears to have a more significant effect on prolactin due to its unique pharmacological mechanism.However,the use of aripiprazole,which is also a new atypical antipsychotic drug,can be seen from a large number of clinical application experience and various research reports that the use of aripiprazole hardly causes prolactin level increase,and even aripiprazole sometimes reduces PRL level.But in terms of female complex endocrine system,and to further understand the antipsychotic drugs in schizophrenia women the influence of the endocrine system,we must need to expand the research scope,more observation must be included in the index,so this study will be incorporated into the progesterone(P),prolactin(PRL),follicle-stimulating hormone(FSH),luteinizing hormone(LH),follicle-stimulating hormone and luteinizing hormone(FSH/LH)between the ratio.Considering the complexity of the female endocrine function of gonad axis,thus,this study proposed by discussing the set pp azole and tolbutamide will benefit to female patients with first-episode schizophrenia P,PRL,FSH,LH,FSH/LH and menstrual conditions to evaluate the effect of two drugs affect the hypothalamus-pituitary-ovarian axis function,and to evaluate the effectiveness of the two kinds of drug treatment,further for childbearing age women patients with first-episode schizophrenia treatment and prognosis assessment.Materials and methods: From October 2016 to December 2018,this study included 59 cases of premenopausal female patients with schizophrenia with the first onset of outpatient and inpatient treatment in the seventh people’s hospital of dalian.All subjects met the diagnostic criteria of icd-10 classification of mental and behavioral disorders and were clearly diagnosed as schizophrenic.In this study,all patients were randomly divided into two groups,namely aripiprazole group and amisulpride group.There were 30 subjects in the aripiprazole group and 29 subjects in the amisulpride group.Patients in the two groups were added slowly until the effective dose,and when the effective dose was reached,the dosage was maintained to observe the patient’s condition,and symptomatic treatment was given when adverse reactions occurred.The positive and negative symptom scale(PANSS)was assessed by the attending physicians and psychiatrists above the level of consistency training on the first day of admission and 4,8 and 12 weeks after medication,and PRL,P,FSH and LH levels were tested by blood sampling.Using SPSS statistical software version 23.0 process analysis of the collected data,measurement data are accord with normal distribution,with x ? + s.Independent sample t test was used for comparison between the two groups.Paired sample t test was used for comparison between the two groups at 4,8 and 12 weeks before and after treatment.Alpha =0.050 was the test standard,p<0.050 had statistical significance.The chi-square test was used to compare the menstrual status between the two groups,p<0.050 had statistical significance.Results: 1.The results of this study showed that the positive and negative symptom scale(PANSS)scores were compared before and after treatment in the aripiprazole group and the amisulpride group,and the differences were statistically significant(P<0.050).The positive and negative symptom scale(PANSS)scores before and at 4,8 and 12 weeks after treatment were compared between the aripiprazole group and amisulpride group,and the differences were not statistically significant(P>0.050).See table 1.2.The results of this study showed that the PRL level in the aripiprazole group was statistically significant before and after treatment at 4,8 and 12 weeks(P<0.050).Are shown in table 2.P,FSH,LH,FSH/LH levels in the aripiprazole group before and after treatment at 4,8 and 12 weeks showed no statistically significant differences(P>0.050).See tables 3,4,5 and 6.3.The results of this study showed that there were statistically significant differences in PRL levels before and after treatment at 4,8 and 12 weeks(P<0.050).Are shown in table 2.There were no statistically significant differences in P,FSH,LH,FSH/LH levels before and after treatment(P>0.050).See tables 3,4,5 and 6.4.The results of this study showed that PRL,P,FSH,LH and FSH/LH levels were compared between the aripiprazole group and amisulpride group before and at 4,8 and 12 weeks after treatment respectively.There were statistically significant differences in PRL levels between the two groups at 4,8 and 12 weeks after treatment(P<0.050).FSH levels between the two groups showed statistically significant difference at 4 weeks after treatment(P<0.050).LH level between the two groups at 12 weeks after treatment indicated a statistically significant difference(P<0.050).See tables 2,4 and 5.5.The results of this study showed that there was a statistically significant difference in menstrual status between the aripiprazole group and amisulpride group(P<0.050).As shown in table 7.Conclusion: 1.There was no difference between aripiprazole and amisulpride in improving the efficacy of first episode schizophrenia in women of reproductive age;2.Aripiprazole was significantly correlated with decreased prolactin levels;Amisulpride was significantly correlated with increased prolactin levels,and was also associated with changes in follicle-stimulating hormone,luteinizing hormone levels and amenorrhea,and affected the function of the hypothalamic-pituitary-ovarian axis.3.Aripiprazole is recommended for the treatment of first-episode schizophrenia in women of reproductive age. |
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