左旋千金藤啶碱与奋乃静治疗精神分裂症双盲比较  

A double-blind comparison trial of l-stepholidine and perphenazine in treatment of schizophrenia

作　　者：吴多琛 邢向忠 王文安[1] 谢虹[1] 王艳华[1] 王秀英[1] 殷俊凤 孙启忠[1] 丛中[2] 金国章[3] 

机构地区：[1]泰安市精神卫生中心,山东泰安271021 [2]泰山医学院精神医学教研室,山东泰安271000 [3]中国科学院上海生命科学研究院药物研究所,上海200031

出　　处：《中国新药与临床杂志》2003年第3期155-160,共6页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的 :研究左旋千金藤啶碱 (SPD)特有的D1受体激动 D2 受体阻滞双重作用对精神分裂症的治疗效果。方法 :住院病人 61例随机分为SPD组和奋乃静组的双盲对照研究。SPD组 (n =31)服用SPD 2 2 5～ 62 5mg·d- 1,奋乃静组 (n =30 )服用奋乃静 16～ 4 4mg·d- 1,分别为 8wk。结果 :SPD组完全缓解率为 71% (2 2 /31) ,奋乃静组为 5 0 %(15 /30 ) ;显著进步分别为 10 % (3/31) ,2 3%(7/30 )。SPD组的有效率为 80 % ,奋乃静组为73%。SPD组的简明精神病量表 (BPRS)疗效在 2 ,4wk时显著强于奋乃静组 (P <0 .0 5 )。SPD组的阴性症状评定量表 (SANS)和阳性症状评定量表(SAPS)疗效显著强于奋乃静组 (P <0 .0 5 )。SPD组的治疗作用显效快。SPD组无锥体外系不良反应 ,SPD组的TESS总分低于奋乃静组 (P <0 .0 5 )。结论 :SPD对精神分裂症有疗效 ,出现快 ,对阳性和阴性症状疗效优于奋乃静 。AIM: To investigate clinical effects of l stepholidine(SPD) with dual D 1 agonistic and D 2 antagonistic actions in the treatment of schizophrenia. METHODS: Sixty one inpatients were randomly divided into SPD group(31 patients) and perphenazine group(30 patients) which were treated with SPD 225～625 mg·d -1 and perphenazine 16～44 mg·d -1 , for 8 wk. The clinical efficacy was measured with the Brief Psychotic Rating Scale(BPRS), the Scale for Assessment of Postitve Symptoms(SAPS), the Scale for Assessment of Negative Symptoms(SANS), and the Clinical Global Impression(CGI). The adverse reactions were determined by the Treatment Emergent Symptom Scale(TESS) and the Rating Scale for Extrapyramidal Side Effects(RSESE). RESULTS: In the SPD group, 71 % inpateints(22/31) completely relieved, 10 %(3/31) markedly improved, 81 % was effective in total. In the perphenazine group, 50 %(15/30) completely relieved, 23 %(7/30) markedly improved, 73 % was effective in total. The decrease rates of BPRS score were significantly greater in SPD group than those in perphenazine group at 2,4 wk( P <0.05). The decrease rates of SAPS and SANS score in SPD group were also greater than those in the perphenazine group( P <0.05). The effect in SPD group started earlier than that in perphenazine group. SPD group had no extrapyramidal symptoms. The total scores of TESS of SPD group were lower than those of perphenazine group. CONCLUSION: SPD shows a definite effect on the positive and negative symptoms of schizophrenia. And SPD is superior to perphenazine in the treatment of the positive and the negative symptoms of schizophrenia. SPD has no obvious extrapyramidal adverse reactions on the patients.

关 键 词：精神分裂症 双盲法 左旋千金藤啶碱 奋乃静 多巴胺受体 D1激动-D2阻滞双重作用 

分 类 号：R971.41[医药卫生—药品] R749.3[医药卫生—药学]