氯丙嗪与齐拉西酮对精神分裂症患者生活质量影响的对照研究

A control study of effects of chlorpromazine and ziprasidone on the quality of life in patients with schizophrenia

目的探讨药物对精神分裂症患者生活质量的长期影响。方法采用生活满意度量表(LSR)、社会功能缺陷筛选量表(SDSS)、阳性症状和阴性症状评定量表(PANSS)、副反应量表(TESS)对山东省临沂市精神卫生中心符合中国精神障碍分类与诊断标准的使用氯丙嗪或齐拉西酮治疗获临床治愈或显著进步的门诊、住院精神分裂症患者128例进行评定。结果齐拉西酮组两次TESS评分低于氯丙嗪组,差异有显著性(P<0.01),齐拉西酮组患者LSR量表各因子分愿望与已实现、热情与冷漠、自我评价、心境差异有显著性(t=2.455～3.341,P<0.05)高于氯丙嗪组;氯丙嗪治疗组患者家庭外社会活动、家庭内活动过少、婚姻职能、社会退缩、对外界兴趣缺陷程度显著高于齐拉西酮治疗组患者(t=2.869～3.181,P均<0.01),个人生活自理、责任心和计划性的缺陷程度高于齐拉西酮治疗组(t=2.153,2.30,P均<0.05)。多元逐步回归分析显示生活满意度与药物副反应、阴性症状得分成负相关(r=-0.238,-0.211)。结论与氯丙嗪相比服齐拉西酮的精神分裂症患者的生活质量较好,患者主客观生活满意度与药物副反应呈负相关。

Objective To investigate the long-term influence of chlorpromazine and ziprasidone on the quality of life （QOL） in schizophrenic patients. Methods The Life Satisfaction Rating scale（LSR）, Social Disability Screening Sehedule（SDSS）, Positive and Negative Symptoms Scale（PANSS） and Treatment Emergent Symptom Scale（TESS） were applied to assess 128 schizophrenic outpatients, who were met the of CCMD-3 for schizophrenia, and had recovered or significantly improved with the treatment of chlorpromazine or ziprasidone. Results Total scores of TESS in ziprasidone group were significantly lower than those in chlorpromazine group （P〈0.01） . The factor scores of enthusiasm and indifference ,self-assessment and mood in ziprasidone group were significantly higher than those in chlorpromazine group （t=2. 455 to 3. 341 ,P〈0.05 ） . The defective degrees of fewer social activities outside family and inside family, marriage function, social withdrawal and, interests to the environment were significantly higher in the patients of chlorpromazine group than those of ziprasidone group （t=2. 869 to 3. 181,P〈0.01） ,the defective degrees of personal care, responsibility and planning in patients of chlorpromazine group were also higher （t=2. 153,2.30, P〈0.05） . Mutiple stepwise regression analysis showed that the scores of LSR were negatively correlated with the scores of TESS and negative symptoms （r=-0. 238,- 0. 211） . Conclusion Ziprasidone has better effect on the QOL of schizophrenic patients than chlorpromazine , The subjective and objective life satisfactory degrees of the patients have negative relation with the score of TESS.