高剂量奥氮平治疗难治性精神分裂症的疗效  

The Efficacy of High-dose Olanzapine on Refractory Schizophrenia

作　　者：成军[1] 李红[1] 石玉中[1] 

机构地区：[1]河南省精神病医院精神科,新乡453002

出　　处：《中国健康心理学杂志》2013年第9期1287-1289,共3页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划(200803078)

摘　　要：目的探讨高剂量奥氮平治疗难治性精神分裂症的临床疗效,并观察其安全性及不良反应。方法 37例难治性精神分裂症患者被随机分为奥氮平组和氯氮平组,奥氮平组:奥氮平20～40mg/d治疗,氯氮平组:氯氮平200～500mg/d治疗。分别于治疗前、治疗4周、8周、12周应用阳性和阴性症状量表(PANSS)评定临床疗效,采用不良反应量表(TESS)、体格检查、实验室检查、心电图、脑电图评价安全性。结果奥氮平组和氯氮平组PANSS总分及各因子分在治疗4周、8周、12周均显著下降(F=16.456,31.352,13.434,22.277,16.869,34.232,21.026,47.558;P<0.001);治疗前,治疗后4周、8周、12周PANSS总分及阳性、阴性、一般精神病理症状分组间差异无统计学意义。奥氮平组和氯氮平组在治疗中均无严重不良反应发生,两组不良反应差异无统计学意义。结论高剂量奥氮平具有很好的安全性,可代替氯氮平治疗难治性精神分裂症。Objective To investigate the therapeutic effects of high-dose olanzapine on refractory schizophrenic patients and safety,side effect. Methods A total of 37 refractory schizophrenia patients were randomly divided into two groups to receive high- dose olanzapine or clozapine for 12 weeks. The Positive and Negative Symptom Scale （PANSS）was utilized for evaluating clinical ef- ficacy, and the Treatment Emergent Symptom Scale （TESS）was utilized for evaluating the safety at prior treatment,the end of weeks 4,8 and 12. Moreover ,electrocardiogram and electroencephalogram examination were performed at prior treatment,week 4, 8 and 12 for safety evaluation, llesul ts There were significant declines on the total PANSS score ,positive score, negative symptom score,general psychopathology score in two groups at the end of week 4,8 and 12 （F= 16. 456,31. 352,13. 434,22. 277,16. 869, 34. 232, 21. 026,47. 558; P = 0. 000）. No significant differences were found on the total PANSS score, positive score, negative symptom score,general psychopathology score between olanzapine and clozapine group at prior treatment ,the end of week 4,8 and 12 （F = 0. 344,1. 094,0. 095,0. 033;P〉 0. 05）. No serious adverse events occurred at the whole treatment period （Zz= 0. 064, 0. 410, 0. 032, 0. 116, 0. 064; P 〉 0. 05）. Conclusion High-dose olanzapine is safe and effective in treatment of refractory schizophrenia ,and it can be used to instead of clozapine in treatment of refractory schizophrenia.

关 键 词：奥氮平 难治性精神分裂症 氯氮平 疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]