奥沙西泮与劳拉西泮对伴肝功能异常酒精戒断综合征患者的疗效及安全性比较  

A controlled study of the efficacy and safety of oxazepam and lorazepam in the patients with alcohol withdrawal and impaired hepatic function

作　　者：王卓 孙继军[1] 马婉[1] 刘军云[1] 盘圣明[1] Ji-jun;MA Wan;LIU Jun-yun;PAN Sheng-ming(The Seventh People's Hospital of Hangzhou,Hangzhou 310013,China)

机构地区：[1]杭州市第七人民医院,310013

出　　处：《临床精神医学杂志》2018年第6期400-402,共3页Journal of Clinical Psychiatry

基　　金：浙江省卫计委科研基金项目(2017KY543)

摘　　要：目的:比较奥沙西泮与劳拉西泮对伴有肝功能异常的酒依赖患者替代治疗的临床疗效及安全性。方法:将酒依赖患者随机分成奥沙西泮组(48例)和劳拉西泮组(47例),两组在常规对症治疗的基础上,分别口服奥沙西泮或劳拉西泮7 d。采用临床机构酒精依赖戒断评估表(CIWA-Ar)评定疗效,及治疗中出现的症状量表(TESS)评定治疗安全性;同时观察肝功能谷丙转氨酶(ALT)和谷草转氨酶(AST)指标。结果:治疗1 d和2 d,奥沙西泮组CIWA-Ar评分低于劳拉西泮组(t=3. 351,P=0. 001; t=4. 096,P=0. 000);治疗3 d,奥沙西泮组TESS评分低于劳拉西泮组(t=-2. 074,P=0. 041);治疗结束,奥沙西泮组ALT和AST水平低于劳拉西泮组(t=2. 207,P <0. 05; t=4. 472,P <0. 01)。结论:与劳拉西泮相比,奥沙西泮对伴有肝功能异常的酒精戒断综合征患者疗效更好、安全性更高。Objective:To investigate clinical efficacy and safety of oxazepam and lorazepam in treatment of the patients with alcohol withdrawal and impaired hepatic function.Method:A total of patients with alcohol withdrawal and impaired hepatic function were randomly divided into oxazepam group(n=48)and lorazepam group(n=47).Based on conventional support treatment,the 2 groups received oral oxazepam or lorazepam respectively for7days.The curative effect was evaluated by clinical institute withdrawal assessment of alcohol scale(CIWA-Ar)and security was evaluated by alanine aminotransferase,aspartate aminotransferase and treatment emergent symptom scale(TESS).Results:The scores of CIWA-Ar in oxazepam group were lower than in lorazepam group in day1and day2(t=3.351,P=0.001;t=4.096,P=0.000).TESS scores of oxazepam group were lower than that of lorazepam group in day3(t=-2.074,P=0.041).After treatment AST and ALT levels of oxazepam group were lower than that of lorazepam group(t=2.207,P<0.05;t=4.472,P<0.01).Conclusion:Compared to lorazepam treatment,oxazepam in treatment of the patients with alcohol withdrawal and impaired hepatic function has a higher clinical efficacy and higher security.

关 键 词：酒精戒断综合征 奥沙西泮 劳拉西泮 肝功能异常 疗效 

分 类 号：R749.62[医药卫生—神经病学与精神病学]