利培酮与奥氮平替换奋乃静治疗精神分裂症对照研究

A control study of risperidone or olanzapine replacing perphenazine in schizophrenia

目的 评价利培酮与奥氮平替换奋乃静治疗精神分裂症的临床疗效及安全性。方法将原服用奋乃静治疗的257例精神分裂症患者分为A组和B组。A组126例，口服利培酮替换奋乃静治疗，B组131例，口服奥氮平替换奋乃静治疗，观察1a。于入组时及治疗2个月、4个月、6个月、8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。结果治疗各时段两组阳性与阴性症状量表总分减分值均呈持续性增高，治疗12个月末A组有效率为62．5％，B组为69．8％，两组无显著性差异（P〉0．05）。A组锥体外系反应、胃肠道不适、便秘、头晕发生率均显著高于B组（P〈0．05或0．01），体重增加发生率显著低于B组（P〈0．01）。结论利培酮与奥氮平治疗精神分裂症疗效均较显著，但利培酮锥体外系反应发生率高于奥氮平，而体重增加发生率低于奥氮平。

Objective To evaluate the clinical efficacy and safety of risperidone or olanzapine replacing perphenazine in the treatment of schizophrenia. Methods 257 schizophrenics previously on perphenazine were divided into group A（n=126） and B（n=131）, group A took orally risperidone and B olanzapine replacing perphenazine for 1 year. Clinical efficacies were assessed with Positive and Negative Syndrome Scale（PANSS） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） at enrolment and at the end of the 2i nd, 4th , 6th, 8th and 12th month. Results After treatment, score-reducing rate of the PANSS total scores in each peroid of both groups elevated continously, at the end of the 12th month effective rates were respectively 62.5G in group A and 69.8% in B, which showed no significant difference（P〉0.05）. Incidences of extrapyramidal system factions, gastrointestinal malaise, constipation and dizziness were significantly higher（P〈0.05 or 0.01） and that of weight gain was significantly lower（P〈0.01） in group A than B. Conclusion Both risperidone and olanzapine have evident effects on schizophrenia, but the incidence of extrapyramidal system reactions is higher and that of weight gain lower of the former than that of the latter.