利培酮替换氯氮平治疗精神分裂症临床分析

Efficacy study on Risperidone alternated to Clozapine for Schizophrenia patients

目的观察国产利培酮片(单克)对氯氮平治疗效果不佳的精神分裂症患者的疗效。方法将120例目前正在服用氯氮平(300～100mg/d)超过6个月的精神分裂症患者,在1个月内全部撤换为单克片剂口服,持续治疗6周。采用阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)评分评价疗效;采用药物不良反应量表(TESS)、锥体外系不良反应量表(SAS)及描述性记录评价不良反应。结果服用氯氮平治疗效果不佳的精神分裂症患者换服单克治疗6周后,基本痊愈28例(23.33%)、显著进步33例(27.50%)、好转24例(20.00%)、无效26例(21.66%)、恶化9例(7.50%),临床总有效率为70.83%。临床不良反应发生率为56.66%,多较轻微,患者耐受性良好。结论服用氯氮平疗效不佳的精神分裂症患者换服单克后,精神症状缓解明显,不良反应轻微,值得临床参考。

Objective To observe the efficacy of Risperidone alternated to Clozapine for Schizophrenia patients. Method The 120 schizophrenia patients who had been taken clozapine （300 to 100 mg/d） over 6 months were changed using clozapine tablet （named DANKE in Chinese） by oral within 1 month, and sustained 6 weeks. The effect was evaluated by the Positive And Negative Symptom Scale （PANSS）, Clinical Global Impression Scale （CGI） score; the side effects were described and evaluated by Treatment Emergent Symptom Scale （TESS）, extrapyramidal side effects scale （SAS） and descriptive record. Result After replaced by Risperidone for 6 weeks in poor efficacy Schizophrenia patients used clozapine, there were full recovery in 28 cases （23.33%）, significant progress in 33 cases （27.50%）, improvement in 24 cases（20.00%）, non-response in 26 （21.66%）, and deterioration in 9 cases （7.50%）.The clinical total effective rate was 70.83%. The incidence of clinical side effects was 56.66%, the majority of them was relatively minor, patients had a good tolerance. Conclusion After replaced by Risperidone for 6 weeks in poor efficacy Schizophrenia patients used clozapine, psychiatric symptoms are alleviated significantly, and adverse reaction is minor. These result should be as a reference to clinical applications.