齐拉西酮与奥氮平治疗以阴性症状为主的精神分裂症对照研究  

A control study of ziprasidone vs olanzapine in the treatment of schizophrenia characterized by negative symptoms

作　　者：张帆[1] 康建华[1] 李哲[1] 

机构地区：[1]云南省精神病医院,云南昆明650224

出　　处：《临床心身疾病杂志》2009年第4期289-291,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的评价齐拉西酮与奥氮平治疗以阴性症状为主的精神分裂症的临床疗效和安全性。方法将86例以阴性症状为主的精神分裂症患者随机分为两组，每组各43例，研究组口服齐拉西酮治疗，对照组口服奥氮平治疗，观察8w。于治疗前及治疗2w、4w、6w、8w末采用阳性与阴性症状量表、阴性症状量表评定临床疗效，副反应量表评定不良反应。结果研究组显效率为74．4％，对照组为79．1％，两组显效率无显著性差异（χ^2=0．261，P〉0．05）。治疗后两组阳性与阴性症状量表、阴性症状量表总分和各因子分均较治疗前显著下降；同期两组间比较均无显著性差异（P〉0．05）。两组不良反应均为轻、中度，多出现在治疗初期，随着治疗时间的延续或对症处理均可缓解或消失。研究组总不良反应发生率为60．5％，对照组为62．8％，两组间无显著性差异（P〉0．05）。结论齐拉西酮与奥氮平治疗以阴性症状为主的精神分裂症疗效显著且相当，不良反应轻微，安全性高，依从性好。Objective To evaluate the efficacy and safety of ziprasidone vs olanzapine in treating schizophrenia characterized by negative symptoms. Methods 86 schizophrenics with negative symptoms predominantly were randomly assigned to two groups of 43 patients each, research group took orally ziprasidone and control group did olanzapine for 8 weeks. Efficacies were assessed with the Positive and Negative Syndrome Scale（PANSS） and the Scale for Assessment of Negative Symptoms（SANS） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the ned of the 2^nd ,4^th ,6^th and 8^th week treatment. Results Obvious effective rates were respectively 74.4% in the research and 79.1% in the control group,which showed no significant difference（P〉0.05）. After treatment, total and all factors＇ scores of the PANSS and SANS of both groups lowered more significantly compared with pretreatment;there were no significant differences in synchronization intergroup comparisons（P〉0.05）. Adverse reactions of both groups were mild to moderate, took place in the initial stage mostly and could relieve or disappear along with time of therapy lasting or by symptomatic treatment. Incidences of adverse raections were respectively 60.5% in the research and 62.8% in the control,which showed no significant difference （P〉0.05）. Conclusion Both ziprasidone and olanzapine have an evident effect which is equivalent,mild adverse reactions, higher safety and better compliance in treating schizophrenia characterized by negative symptoms The results suggested that Ziprasidone was as effective as Olanzapine in the treatment of schizophrenia with predominantly negative symptoms and had fewer side effects in them. Both of them are effective and safe antipsychotic drugs in the treatment of schizophrenia with negative symptoms predominantly.

关 键 词：精神分裂症 阴性症状 齐拉两酮 奥氮平 阳性与阴性症状量表 阴性症状量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R971.41[医药卫生—临床医学]