泰必利与奋乃静治疗酒精所致精神障碍的临床观察

CLINICAL OBSERVATION ON TIAPRIDE AND PERPHENAZINE FOR THE TREATMENT OF PATIENTS WITH ALCOHOL INDUCED MENTAL DISORDERS

目的:比较泰必利与奋乃静治疗酒精所致精神障碍的疗效和安全性。方法:共纳入63例酒精所致精神障碍患者,其中泰必利组32例,剂量为200mg·d-1±s12mg·d-1;奋乃静组为31例,剂量为16.0mg·d-1±s3.4mg·d-1;疗程共8周。在治疗前和治疗的第4、8周末分别对其神经、精神症状是否缓解进行评定,并采用《临床疗效总评量表》(CGI)及《治疗中需处理的副反应量表》(TESS)在治疗前和治疗的第1、2、4、6、8周末分别评定疗效和副反应。结果:(1)两组患者治疗后的神经、精神症状均显著好转(P<0.01);(2)两组间CGI评分差异无统计学意义(P>0.05),泰必利与奋乃静的有效率分别为78.1%和74.2%,疗效差异无统计学意义(P>0.05);(3)两组TESS评定显示,泰必利组在神经系统副反应显著少于奋乃静组(P<0.001),植物神经系统副反应也明显少于奋乃静组(P<0.05)。治疗期间奋乃静组合用安坦16例(51.6%),泰必利组7例(21.9%),差异有统计学意义(P<0.05)。结论:泰必利治疗酒精所致精神障碍疗效好、不良反应较奋乃静少而轻。

Objective：To observe the efficacy and safety of tiapride and perphenazine in the treatment of alcohol induced mental disorders. Methods：Sixty three patients with alcohol induced mental disorders were recruited in the study, with 32 treated with tiapride 200 mg·d^-1±s 12 mg·d^-1 and 31 with perphenazine 16.0 mg·d^-1±s 3.4 mg·d^-1 for 8 weeks. Assessment on the symptoms of neuropsychosis was conducted before and at the end of 4 weeks and 8 weeks on treatment. The Clinical Global Impressions Scale（CGI）and Treatment Emergent Symptoms Scale （TESS） were used to measure the therapeutic efficacy and side effects, respectively before treatment and at the end of 1, 2, 4, 6, 8 weeks on treatment. Results：（1）After treatment, the symptoms of neuropsychosis of the patients in both groups were improved significantly compared to that before treatment, （P〈0.01）; （2）CGL scores of the two groups showed no significant difference（P〉0.05）, and the rate of improvement was similar（78.1% vs 74.2%,P〉0.05）; （3）TESS showed that tiapride had less side effects than perphenazine（P〈0.001 or P〈0.05）. During the treatment, 16 cases（51.6%）in Perphenazine group and 7 cases（21.9%） in Tiapride group used benzhexol,showing significant difference（P〈0.05）. Conclusion：Tiapride has good treatment efficacy with higher safety and fewer side effects for treatment of patients with alcohol induced mental disorders.