非典型抗精神病药物治疗痴呆精神行为症状的临床研究

Clinical trial of atypical antipsychotics in patients with behavioral and psychological symptoms of dementia

目的:探讨奥氮平、利培酮、喹硫平小剂量短期治疗对痴呆伴发精神行为症状(BPSD)的影响和安全性。方法:连续性入组BPSD患者,随机进入奥氮平、利培酮、喹硫平和空白对照组,随访4周,评定工具:神经精神科问卷(NPI)、治疗副反应量表等。结果:2周末喹硫平组的NPI减分值大于空白组,4周末奥氮平和喹硫平组的减分值大于空白组(P<0.05)。和空白组比较,只有喹硫平组便秘不良反应差异有统计学意义(P<0.05)。利培酮组无严重不良事件。结论:奥氮平、喹硫平小剂量、短期使用能有效改善BPSD,利培酮在安全性上可能有优势。

Objective To explore the influence and safety of short-term therapy of Olanxapine,Risperidone and Quediapine on patients with behavioral and psychological symptoms.Methods designing the prospective clinical case-control test and randomly dividing patients in olanzapine,risperidone,quetiapine and blank control groups.The total treatment follow-up time is 4 weeks.Assessment tools include the Neuropsychiatric Inventory(NPI),Treatment Emergent Symptom Scale(TESS)and et al.Results the NPI subtraction score of quetiapine in 2 weeks is larger than that of the blank group;the reduction values of olanzapine and quetiapine groups in 4 weeks are larger than that of the blank group(P<0.05).The occurrence frequency of side effect constipation in the quetiapine group is significantly higher than other groups.Only no serious adverse incidents occur in risperidone Group.Conclusions small doses of atypical antipsychotics olanzapine and quetiapine could effectively improve the behavioral and psychological symptoms of dementia.Risperidone may have potential advantage in safety.