齐拉西酮联合奥氮平治疗精神分裂症后单一巩固治疗的疗效研究  

The control study of ziprasidone and olanzapine in consolidation therapy of schizophrenia patients

作　　者：唐建良 金卫东[2] 江长旺[3] 蒋永红[4] 

机构地区：[1]桐乡市第一人民医院精神科,浙江桐乡314500 [2]浙江省立同德医院精神科,浙江杭州314000 [3]杭州市第七人民医院,浙江杭州314000 [4]湖州市第三人民医院,浙江湖州313000

出　　处：《中华全科医学》2016年第7期1083-1085,1242,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生一般研究项目(2014KYB273);浙江省嘉兴市科技计划项目(2014AY21064)

摘　　要：目的观察齐拉西酮联合奥氮平治疗精神分裂症后单一巩固治疗的疗效与安全性。方法选取197例精神分裂症患者,起始为齐拉西酮联合奥氮平治疗,5周后随机分为齐拉西酮合并奥氮平组98例(联用组),单用齐拉西酮组99例(单药组),所有入组患者在治疗前、治疗后1、5、7、9、12周末使用阳性症状与阴性症状量表(PANSS)、临床疗效总评量表(CGI)、不良反应症状量表(TESS)评定患者临床症状严重程度与药物不良反应。结果治疗后1、5、7、9、12周末时2组间同时段PANSS、CGI评分比较差异无统计学意义(P>0.05)。与治疗前比较,单药组与联用组在治疗1周末时,PANSS评分均开始持续下降(t=-4.76,P=0.00;t=-8.89,P=0.00),治疗后5、7、9、12周末与治疗前比较差异均有统计学意义;单药组与联用组在治疗1周末,CGI评分均开始持续下降(t=-1.84,P=0.10;t=-1.73,P=0.18),但与治疗前比较差异无统计学意义,治疗后5、7、9、12周末,与治疗前比较差异均有统计学意义;2组TESS评分比较,在治疗第7周末、第12周末差异有统计学意义(P<0.05),联用组部分患者出现体质量增加,体重指数、血压升高等。结论齐拉西酮联合奥氮平治疗精神分裂症5周后,单用齐拉西酮治疗与联合奥氮平使用疗效相当,单用齐拉西酮组不良反应相对较少,改善治疗依从性,可能有利于患者长期维持治疗。Objective One hundred and ninety-seven cases were selected into the trial. All the patients were administered with ziprasidone and olanzapine within the first 5 weeks. After 5 weeks all patients were randomly divided into combination group （98 cases administered with ziprasidone and olanzapine） and single group （99 cases administered only with ziprasi- done）. All patients were assessed by Positive And Negative Syndrome Scale （PANSS） , Clinical Global Impression Scale （ CGI）, Treatment Emergent Symptom Scale （TESS） before treatment and at the 1^ st, 5^th, 7^th,9^th, 12th weekend after treat- ment. Results The scores of PANSS of both 2 groups started to decrease at the 1 at weekend compared with pre-treatment （ t = - 4.76, P = 0.00 ; t = - 8.89, P = 0.00） , and there was significant difference in scores of PANSS at the 5^th,7^th,9^th, 12^th weekend after treatment（P 〉 0.05） in both two groups compared with pretreatment. The scores of CGI of both 2 groups started to decrease at the 1^st weekend, but they didn＇ t have statistical difference compared with pre-treatment（t = - 1.84,P =0.10;t = - 1.73 ,P =0.18） ,while there were statistical differences in scores of CG1 at the 5^th ,7^th ,9^th, 12th weekend after treatment （ P 〉 0.05 ） in both two groups when compared with pretreatment. There was significant difference in scores of TESS between the 2 groups at the 7^th and 12^th weekend after treatment （P 〈 0.05）. Conclusion After 5- week treatment with ziprasidone and olanzapine ,the efficacy of consolidation treatment by single ziprasidone was almost a- mount to that by combination of ziprasidone and olanzapine, and the use of single ziprasidone didn＇ t have obvious adverse reaction ,which could improve the patients＇ compliance so as to the benefit of their long-term treatment.

关 键 词：齐拉西酮 奥氮平 精神分裂症 疗效 

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]