利培酮与氯氮平治疗难治性精神分裂症对照研究

Risperidone versus clozapine in treatment-resistant schizophrenia: a randomized controlled study

目的比较利培酮与氯氮平治疗难治性精神分裂症的疗效及安全性。方法将64例难治性精神分裂症患者随机分为氯氮平治疗组34例和利培酮治疗组30例。观察治疗12w,于治疗前及治疗第4、8、12w末采用阳性和阴性症状量表和副反应量表评定临床疗效和不良反应。结果两组治疗后阳性和阴性症状量表评分与治疗前比较均有显著下降,差异均显著或极显著性(P<0.05或0.01)。两组间治疗12w末,氯氮平组总分、阳性症状及一般精神病理因子评分比利培酮组下降显著,差异均有显著性(P<0.05)。氯氮平组治疗第8、12w末副反应量表评定总分均显著高于利培酮组,差异均有显著或极显著性(P<0.05或0.01)。结论利培酮与氯氮平治疗难治性精神分裂症均有良好的疗效。

Objective To compare the efficacy and safety of clozapine and risperidone in treatment-resistant schizophrenic（TRS） patients. Methods 64 in-patients with treatment-resistan-t schizophrenia（CCMD-3） were randomly assigned to receive risperidone（n= 30） or clozapine（n=34） for 12 weeks. The Positive and Negative Syndrome Scale（PANSS） and Treatment Emergent Symptoms Scale（TESS） was used to measure therapeutic efficacy and side effects. Results The PANSS scores in both groups decreased significantly after treatment（P〈0.05 or 0.01）. At the end of week 12, total score, positive and general psychotic scores decreased more significantly in the clozapine group than in the risperidone did, difference was signific-ant（P〈0.05）. The TESS total scores of the clozapine were higher than that of the risperidone group at the ends of week 8 and 12,differences were significant and more significant（P〈0. 05 or 0.01）. Conclusion Both risperidone and clozapine were effective in treatment-resistant schizophrenia.