利培酮氯氮平氯丙嗪治疗首发精神分裂症临床研究

A clinical study of risperidone, clozapirie and chlorproma/ine in patients with first-episode schizophrenia

目的探讨氯丙嗪、氯氮平及利培酮治疗精神分裂症的疗效及安全性。方法将资料完整的86例精神分裂症患者随机分为氯丙嗪、氯氮平和利醅酮(甲、乙、丙)治疗组。其中甲组22例,乙组31例,丙组33例。三组疗程均为12w。氯丙嗪、氯氮平剂量25-600mg·d-1,利培酮1-7mg·d-1。采用潘氏量表及药物副反应量表于治疗前及治疗第4、8、12w末评定临床疗效及不良反应。结果治疗第4、8、12w末三组潘氏量表总分,阳性、阴性症状分及一般病理分均下降;乙组、丙组阳性和阴性症状总分减分率较甲组明显高(P<0．01),乙组与丙组差异无显著性。甲组有效率54．6％,乙组67．7％,丙组69．7％。不良反应利培酮少于氯丙嗪、氯氮平,且未发现白细胞减少及直立性低血压。结论利培酮治疗精神分裂症阴性、阳性症状疗效显著,不良反应少。

Objective To explore the effectiveness and safety of chlorpromazine,clozapine and risperidone in treatment of first-episode schizophrenia. Methods 86 schizophrenics with whole data were randomly divided into chlorpromazine （ n = 22）, clozapine （n = 31） and risperidone （n = 33） group for 12 weeks. Mean dosages of both chlorpromazine and clozapine were 25～600mg/d, that of risperidone 1～7mg/d. Effectiveness and adverse effects were assessed using The Positive and Negative Syndrome Scale（PANSS） and Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of 4th,8th and 12th week of treatment, respectively. Results At the ends of 4th,8th and 12th week of treatment, total, positive ,negative and general scores of the PANSS all reduced in 3 groups. Score reduction rate of total score of positive sand negative symptoms was significantly higher in both clozapine and risperidone groups than in the chlorpromazine（P〈0.01）. There was no significant difference between clozapine and risperidone group. Effective rates were respectively 54.6% in the chlorpromazine group, 67.7% clozapine and 69.7% risperidone. Adverse effects of risperidone were fewer than those of chlorpromazine and clozapine and had no leucopenia and orthostatic hypotension. Conclusion Risperidene has significant effectiveness and fewer adverse effects in positive and negative symptoms of schizophrenia.