阿立哌唑与奋乃静治疗老年期精神分裂症对照研究

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

目的探讨阿立哌唑与奋乃静治疗老年精神分裂症的临床疗效和安全性。方法将82例老年精神分裂症患者随机分为两组，每组41例，研究组口服阿立哌唑治疗，对照组口服奋乃静治疗；观察8周。于治疗前及治疗2周、4周、8周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。结果两组治疗第2周末起，阳性与阴性症状量表总分及各因子分均较治疗前有显著下降（P〈0．01），同期两组问评分均无显著性差异（P均〉0．05）；治疗8周末，研究组显效率75．61％，有效率92．68％；对照组分别为70．73％，90．20％。两组显效率、有效率比较均无显著性差异（P〉0．05）。两组不良反应多发生在治疗初期，程度较轻微，但研究组体重增加、失眠、锥体外系反应、泌乳发生率显著低于对照组（P〈0．05）。研究组完全依从率显著高于对照组（X2=5．917，P〈0．05）。结论阿立哌唑与奋乃静治疗老年精神分裂症疗效显著且相当，但阿立哌唑安全性更高，依从性更好，更适合老年精神分裂症的治疗。

Objective To explore the clinical efficacy and safety of aripiprazole vs perphenazine in the treatment of senile schizophnia. Methods Eighty-two senile schizophnics were randomly divided into two groups of 41 patients each. Research group took orally aripiprazole and control group did perphenazine for 8 weeks. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale（PANSS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 2nd, 4th and 8th week. Results Since the end of the 2nd week, the total and each factor scores of the PANSS of both groups lowered more significantly compared with pretreatment（P〈0.01）, there were no significant differences in synchronization group comparisons （all P〉0.05） ; at the end of the 8th week, obvious effective and effective rates were 75.61% and 92.68% in the research and 70.73% and 90. 20% in the control group, respectively, which showed no significant differences（P〉0.05）. Adverse reactions of both groups mainly taken place in the initial stage of treatment and were mild, but the incidence rates of weight gain, insomnia, extrapyramidal system raections and lac- tation were significantly lower in the research than in the control group（P〈0.05）. The rate of complete compliance was significantly higher in the research than in the control group （x2 =5. 917,P〈0.05）. Conclusion Both aripiprazole and perphenazine are effective in the treatment of senile schizophrenia, but aripiprazole has higher safety and better compliance and is more suitable for senile schizophrenia.