奥氮平与利培酮治疗血管性痴呆伴发精神行为症状对照研究  

A control study of olanzapine vs.risperidone in behavioral and psychological symptoms of vascular dementia

作　　者：刘新轶[1] 

机构地区：[1]天津市公安局安康医院,中国·天津300240

出　　处：《临床心身疾病杂志》2011年第6期510-511,514,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的 探讨奥氮平与利培酮治疗血管性痴呆伴发精神行为症状的疗效与安全性.方法 将86例血管性痴呆伴发精神行为症状患者分为奥氮平组与利培酮组,每组43例,在常规治疗的基础上分别口服奥氮平与利培酮治疗,观察8周.于治疗前及治疗2周、4周、8周末采用痴呆行为量表评定临床疗效,日常生活能力量表评定生活自理能力状况,副反应量表评定不良反应.结果 治疗后两组痴呆行为量表及日常生活能力量表评分均较治疗前显著下降（P＜0.01）,但奥氮平组治疗2周末痴呆行为量表评分较利培酮组下降更显著（P＜0.05）,其他时段评分两组差异均无显著性（P＞0.05）.奥氮平组不良反应发生率为30.2%,利培酮组为48.8%,奥氮平组失眠、锥体外系反应、兴奋激越发生率显著低于利培酮组（P＜0.01）,而嗜睡发生率显著高于利培酮组（P＜0.05）.结论 奥氮平与利培酮治疗血管性痴呆伴发精神行为症状疗效均显著,但奥氮平起效更快,安全性更高,依从性更好.Objective explore efficacy and safety of olanzapine psychological symptoms （BPS） of vascular dementia （VD）. Methods vs. risperidone in behavioral and Eighty-six BPS-VD patients were divided into olanzapine （n=43） and risperidone group （n=43） ,based on routine treatment they orally took olanzapine or risperidone for 8 weeks. Before treatment and at the end of the 2nd, 4th and 8th week, clinical efficacies were assessed with the Behavior Rating Scale for Dementia （BRSD）, self-care ability with the Activities of Daily Living Scale （ADL） and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results After treatment, scores of the BRSD and ADL of both groups lowered more significantly compared with pretreatment （P〈0. 01）, but the BR.SD score lowered lowered more significantly in olanzapine than risperidone group at the end of the 2nd week （P〈0.05）, there were no significant differences in other periods （P〉0.05）. The incidences of adverse reactions were respectively 30.2% in olanzapine and 48.8% in risperidone group, incidences of insomnia, reaction of extrapyramidal system and excitation/agitation were significantly lower （P〈0.01） and that of lethargy higher in the former than in the lat ter （P〈0.05）. Conclusion Both olanzapine and risperidone are effective in BPS-VD, but the former takes effect more rapidly and has higher safety and better compliance.

关 键 词：血管性痴呆 精神行为症状 奥氮平 利培酮 痴呆行为量表 日常生活能力量表 副反应量表 

分 类 号：R749.16[医药卫生—神经病学与精神病学]