治疗首发精神分裂症2种药物比较  

Comparison of two drugs in the treatment of first-episode schizophrenia

作　　者：庞军委 郑高健 张卫华[1] 唐旭 PANG Junwei;ZHENG Gaojian;ZHANG Weihua;TANG Xu(Department of Psychiatry,The Second People's Hospital of Taizhou,Taizhou,Zhejiang 317200,China)

机构地区：[1]台州市第二人民医院精神科,浙江台州317200

出　　处：《预防医学》2024年第5期416-419,共4页CHINA PREVENTIVE MEDICINE JOURNAL

摘　　要：目的比较布南色林和奥氮平治疗首发精神分裂症的效果,为精神分裂症治疗药物选择提供参考。方法选择台州市第二人民医院收治的首发精神分裂症病例98例,随机纳入奥氮平组与布南色林组,疗程为2个月。治疗前后,采用阳性和阴性症状量表(PANSS)、匹兹堡睡眠质量指数量表(PSQI)、精神分裂症认知功能成套测验-中文版(MCCB)分别调查症状改善情况、睡眠质量和认知功能,检测泌乳素,采用广义估计方程比较两组治疗前后指标差异;记录不良反应,评价用药安全性。结果两组各纳入49例首发精神分裂症病例。奥氮平组男性29例,年龄为(37.22±7.17)岁;布南色林组男性27例,年龄为(37.54±7.31)岁;两组性别、年龄、病程和受教育年限差异无统计学意义(均P>0.05)。治疗后,两组病例的阳性症状评分、阴性症状评分、一般精神病理评分和PANSS总分较治疗前下降(均P<0.05),但组间差异无统计学意义,且药物与治疗时间不存在交互作用(均P>0.05)。布南色林组MCCB评分高于奥氮平组,PSQI评分、泌乳素水平低于奥氮平组,且药物与治疗时间存在交互作用(均P<0.05)。布南色林组不良反应发生率为6.12%,低于奥氮平组的20.41%(P<0.05)。结论首发精神分裂症病例采用布南色林或奥氮平治疗均可改善精神病性症状,布南色林改善睡眠质量、认知功能和降低泌乳素水平的效果优于奥氮平,且安全性相对较高。Objective To compare the effectiveness of blonanserin and olanzapine in the treatment of first-episode schizo⁃phrenia,so as to provide the basis for the medication choice for the treatment of first-episode schizophrenia.Methods A total of 98 patients with first-episode schizophrenia admitted to the Second People's Hospital of Taizhou City were se⁃lected and randomly divided into the olanzapine group and the blonanserin group for a treatment period of two months.The Positive and Negative Syndrome Scale(PANSS),Pittsburgh Sleep Quality Index(PSQI),MATRICS Consensus Cogni⁃tive Battery(MCCB)were used to investigate the improvement of symptoms,sleep quality and cognitive function before and after treatment,respectively,and the level of prolactin was detected.The generalized estimation equation was used to compare the differences between the two groups.The adverse reactions of the two groups were recorded and the safe⁃ty of medication was evaluated.Results Forty-nine patients each group were included,with 29 males and a mean age of(37.22±7.17)years in the olanzapine group,and 27 males and a mean age of(37.54±7.31)years in the blonanserin group.There were no significant differences in gender,age,disease course and educational duration between the two groups(all P>0.05).The scores of positive symptom,negative symptom,general psychopathology and overall PANSS in the two groups after treatment were decreased compared with those before(all P<0.05).However,there was no signifi⁃cant difference between the two groups,and no interaction between the drugs and treatment duration(all P>0.05).The MCCB score of the blonanserin group was higher than that of the olanzapine group,while the PSQI score and the pro⁃lactin level of the blonanserin group were lower than that of the olanzapine group,and there was an interaction between the drugs and treatment duration(all P<0.05).The incidence of adverse reactions in the blonanserin group was 6.12%,which was lower than that in the olanzapine group of 20.41%(P<0.05).Conclusion Ei

关 键 词：精神分裂症 布南色林 奥氮平 睡眠质量 认知功能 泌乳素 安全性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]