阿立哌唑对慢性精神分裂症患者临床疗效和生活质量的影响

Influences of aripiprazole on clinical efficacy and quality of life of chronic schizophrenia patients

目的探讨阿立哌唑与氯丙嗪对慢性精神分裂症患者临床疗效和生活质量的影响。方法将210例慢性精神分裂症患者随机分为两组各105例，研究组口服阿立哌唑治疗，对照组口服氯丙嗪治疗，观察12个月。于治疗前及治疗第2个月、6个月、12个月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、世界卫生组织编制的生活质量量表评定生活质量。结果治疗2周末起，两组阳性与阴性症状量表总分、阳性症状、阴性症状及精神病理因子分均较治疗前显著下降（P均〈0．01），同期两组间评分均无显著性差异（P均〉0．05）。治疗12个月末，研究组显效率62．86％、有效率87。62％，对照组分别为65．71％、88．57％，两组无显著性差异（P〉0．05）。治疗后研究组不良反应发生率为24．76％，对照组为51．43％，研究组显著低于对照组（X^2=15．831，P〈0．01）；研究组各时段副反应量表评分均显著低于对照组（P〈0．01）。治疗后两组生活质量量表各因子评分均较治疗前显著提高（P〈0．01），同期研究组均较对照组提高显著（P〈0．05或0．01）。结论阿立哌唑与氯丙嗪治疗慢性精神分裂症疗效相当，但阿立哌唑不良反应轻微，安全性高，对患者生活质量的改善显著优于氯丙嗪。

Objective To explore the influences of aripiprazole and chlorpromazine on clinical efficacy and quality of life of chronic schizophrenia patients. Methods 210 chrinic schizophrenics were randomly assigned to two groups of 105 patients each, research group took orally aripiprazole and control group did chlorpromazine for 12 months. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS）,adverse reactins with the Treatment Emergent Symptom Scale （TESS） and quality of life with the WHO Quality of Life Scale（WHOQOL） before treatment and at the end of the 2nd,6th and 12th month. Results Since the end of the 2nd month, the total, positive, negative symptom and psychopathology scores of the PANSS of both groups lowered more significantly compared with pretreatment（all P〈 0.01） ,there were no significant differences in group comparisons in the corresponding time period（all P〉 0.05）. At the end of the 12th month, obvious effective and effective rates were 62.86% and 87.62% in the research and 65.71% and 88.57% in the control group, respectively, which showed no significant differences（P〉0.05）. Incidences of adverse reactions were respectively 24. 76% in the research and 51.43% in the control group, the former was significantly lower than the latter（X^2 = 15. 831, P〈0.01） TESS scores of each period were all significantly lower in the research than in the control（P〈0.01）. After treatment, WHOQOL scores of both groups elevated more significantly compared with pretreatment （P〈0. 01）, so did in the research than in the control in the corresponding time period（P〈0.05 or 0. 01） . Conclusion Aripiprazole has therapeutic equivalence to chlorpromazine in schizophrenia, but the former has mild adverse reactions, higher safety and an advantage over the latter in improving quality of life.