5种新一代抗精神病药治疗首发精神分裂症的对照研究  

Comparative efficacy,acceptability and safety of 5 new-generation antipsychotics in treating first-episode schizophrenia

作　　者：石文杰[1] 王从杰[1] 朱建南[1] 陈刚[1] 黄成兵[1] 

机构地区：[1]江苏省淮安市第三人民医院,淮安223001

出　　处：《国际精神病学杂志》2016年第1期24-28,共5页Journal Of International Psychiatry

摘　　要：目的比较利培酮、喹硫平、奥氮平、阿立哌唑和齐拉西酮治疗首发精神分裂症的疗效、可接受性及安全性。方法将200例首发精神分裂症患者随机给予上述5种之一的新一代抗精神病药治疗;采用《简明精神病量表》评定临床疗效,同时比较5种抗精神病药物的可接受性（合并用药率、换药率及维持原药率）和不良反应。结果 1临床疗效：阿立哌唑、利培酮、喹硫平、奥氮平、齐拉西酮治疗首发精神分裂症患者后BPRS评分较治疗前差异均有统计学意义（P〈0.01）;经方差分析和LSD检验提示,利培酮组BPRS减分率显著高于阿立哌唑组（P〈0.01）和奥氮平组（P〈0.05）。2可接受性比较：经χ2检验提示（χ^2=15.55,P=0.049）;经过分割χ2检验,奥氮平较阿立哌唑、齐拉西酮差异均有统计学意义（P〈0.05）;同时喹硫平较齐拉西酮差异也有统计学意义（P〈0.05）。3不良反应比较：在锥体外系反应、ECG改变、肝功能异常、便秘、白细胞减少5个方面差异均无统计学意义（均P〉0.05）。结论 5种新一代抗精神病药治疗精神分裂症首次发病患者疗效均较好,奥氮平、喹硫平可接受性较好;5种药物之间不良反应类似。Objective To explore the efficacy,acceptability and safety of 5 new-generation antipsychotics（ e. g. aripiprazole,resperidone,quetiapine,olanzapine,ziprasidone） in treating first-episode schizophrenia.Methods 200 cases of first-episode schizophrenia were recruited and randomly given one of 5 new-generation antipsychotics respectively when inclusion. Clinical efficacy was assessed by Brief Psychiatric Rating Scale,acceptability was evaluated mainly by drug combination,change another medication proportion and maintain original drug rate of each antipsychotics,and safety of each antipsychotics were estimated by its side effects. Results 1. BPRS scores after treatment were all significantly decreased than prior treatment in each of 5 new-generation antipsychotics（ all P value〈 0. 01）. While BPRS reduction scores of resperidone were markedly higher than that of aripiprazole（ P〈0. 01） and olanzapine（ P〈0. 05） 2. Acceptability of olanzapine was remarkably better than that of aripiprazole（ P =0. 027） and ziprasidone（ P =0. 015）,meanwhile,quetiapine was also markedly better than that of ziprasidone（ P =0. 037）. 3. The difference of EPS,changes of ECG,abnormal liver functions,constipation and leukopenia among 5 new-generation antipsychotics were not detected. Conclusion The efficacy of 5 new-generation antipsychotics in treating first-episode schizophrenia were all significant,The acceptability of olanzapine and quetiapine were better among 5 new-generation antipsychotics,Side effects of 5 new-generation antipsychotics were similar.

关 键 词：首发 精神分裂症 抗精神病药 疗效 可接受性和安全性 

分 类 号：R749.05[医药卫生—神经病学与精神病学]