阿立哌唑与氯丙嗪治疗老年精神分裂症对照研究

A control study of aripiprazole vs chlorpromazine in the treatment of senile schizophrenia

目的探讨阿立哌唑与氯丙嗪治疗老年精神分裂症的临床疗效和安全性。方法将96例精神分裂症患者随机分为两组各48例，研究组口服阿立哌唑治疗，对照组口服氯丙嗪治疗，观察8w。于治疗前及治疗第2w、4w、6w、8w末采用阳性与阴性症状量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表总分均较治疗前有显著性下降（P〈0．01），治疗8w末，研究组总分及各因子分较治疗前下降显著（P〈0．01），对照组总分、阳性症状、一般病理因子分较治疗前下降显著（P〈0．01），而阴性症状因子分无显著变化（P〉0．05）；研究组阴性症状因子分显著低于对照组（P〈0．05）。两组显效率无显著性差异（P〉0．05）。研究组不良反应发生率及各时点副反应量表评分均显著低于对照组（P均〈0．05）。结论阿立哌唑治疗老年精神分裂症疗效与氯丙嗪相当，但改善阴性症状显著优于氯丙嗪，且安全性高，依从性好。

Objective To explore the clinical efficacy and safety of aripiprazole vs chlorpromazine in the treatment of senile schizophrenia. Methods 96 schizophrenics were randomly assigned to two groups of 48 patients each, research group took orally aripiprazole and control group did chlorpromazine for 8 weeks. Before treatment and at the end of the 2^nd, 4^th, 6^th and 8^th week, clinical efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results After treatment, the total scores of the PANSS of both groups lowered more significantly compared with pretreatment（P〈0.01） ; at the end of the 8^th week, total and all factor scores in the research group lowered more significantly compared with pretreatment （P〈0.01）, in total, positive symptom and general pathology, and no in negative symptom（P〉0.05） ; negative symptom scores were significantly lower in the research than in the control group（P〈0.05）. Obvous effective rates were not significantly different between the two groups（P〉0. 05）. Incidences of adverse reactions and each timepoint TESS score were all significantly lower in the research than in the control group（all P〈0.05）. Conclusion Aripiprazole has therapeutic equivalence to chlorpromazine in senile schizophrenia,is more effective than the latter on negative symptoms, and has higher safety and better compliance.