利培酮和氯氮平治疗伴抑郁症状的难治性精神分裂症对照研究

Controlled study of risperidone versus clozapine in treatment of refractory schizophrenia with depressive symptoms

目的:比较利培酮和氯氮平对伴抑郁症状的难治性精神分裂症疗效。方法:共70例难治性精神分裂症患者随机服用利培酮和氯氮平治疗。利培酮组34例,氯氮平组36例;伴有抑郁症状者39例,利培酮组17例,氯氮平组22例。治疗12周。分别于治疗前、治疗48、、12周末采用阳性与阴性症状量表(PANSS),汉密尔顿抑郁量表(HAMD)及功能大体评定量表(GAF)评定疗效。结果:两组PANSS、HAMD和GAF评分在治疗12周均有显著改善;两组间比较差异无显著性。有、无抑郁症状组在治疗4、8、12周末的HAMD总分与治疗前比较均显著减少。结论:抑郁症状不影响难治性精神分裂症的疗效;利培酮和氯氮平对伴抑郁症状的难治性精神分裂症均有效。

Objective： To compare the efficacy of risperidone and clozapine in the treatment of refractory schizophrenic patients with depressive symptoms. Method： Seventy inpatients with refractory schizophrenia were randomly assigned to risperidone group（ n = 34） or clozapine group（ n = 36）for 12 weeks. Among these patients, 17 schizophrenic patients with depression were in risperidone group and 22 in clozapine group. Positive and negative symptom scale（PANSS）, Hamilton depressive scale（HAMD） and global assessment function（GAF） were used to measure therapeutic efficacy. Results： The scores of PANSS, HAMD and GAF improved significanly after treatment in both groups. There were no obvious differences between two groups. Compared with the scales before treatment, the total score of HAMD decreased significantly after 4,8, 12 weeks treatment in both groups with or without depression.Conclusion： Depressive symptoms have no influences on the efficacy of schizophrenia. Both risperidone and clozapine are effective for refractory schizophrenia with depressive symptoms.