急性期精神分裂症住院患者转换为阿立哌唑治疗疗效及安全性研究

Efficacy and safety after switching to aripiprozole in acute inpatients with schizophrenia

目的探讨急性期精神分裂症住院患者转换为阿立哌唑单药或阿立哌唑合并奋乃静治疗的疗效及安全性。方法入选者住院后将先前药物逐步减量,同时给予阿立哌唑治疗,2周后完全停用先前药物,并随机分为两组,即阿立哌唑合并安慰剂(单一用药组)或奋乃静(合并用药组)治疗8周。以阳性和阴性症状量表(PAN-SS)、临床总体印象严重程度量表(CGI-S)分别评定患者精神症状及总体疾病严重程度;以人际和社会功能量表(PSP)评定其个人和社会功能,以Simpson-Angus量表(SAS)、Barnes静坐不能量表(BARS)和异常不自主运动量表(AIMS)评定治疗过程中可能出现的不良反应,以药物态度问卷(DAI-10)评价患者对目前所服用药物的态度。结果治疗后两组PANSS总分及阳性分、阴性分和CGI-S评分分别较其治疗前有显著改善(P<0.05);治疗8周后,两组间PANSS总分及CGI-S评分无统计学差异,阿立哌唑单药组PSP评分、DAI评分显著高于合并用药组(P<0.05)。结论阿立哌唑能有效控制精神症状,并有较好的耐受性,能够进一步改善患者社会功能及对于服药的态度。

Objective To explore the efficacy and tolerability of treatment with aripiprozole or aripiprozole combined with perphenazine following a switch from prior antipsychotics in inpafients with acute schizophrenia. Methods Patients enrolled this study began to take aripiprozole and their prior antipsychotics were tapered off. After two weeks treatment, all patients stop taking prior antipsychotics and randomly allocated to receive aripiprozole combined with placebo （ single group） or perphenazine combined with perphenazine （combined group） for the treatment of 8 weeks. Positive and Nega- tive Symptom Scale （PANSS） and Clinical Global Impression Severity （CGI -S） were used to assess the efficacy. Per- sonal and Social Performance （PSP） for social function, Simpson -Angus Rating Scale （SAS）, Ihe Barnes Akathisia Scale （BARS）, and the Abnormal Involuntary Movement Scale （AIMS） for tolerability and safety, Drug Attitude Inven- tory （ DAI - 10） for attitude to taking drug. Results The patients of the two groups showed significant improvement in total scores, positive and negative symptoms scores, and PANSS scores of CGT - S after treatment （ P 〈 0.05）. There were no significant differences in PANSS total score and CGI - S score between the two groups after 8 weeks treatment. Patients in single group had significantly higher scores in PSP and DAI than that in combined group （ P 〈 0.05）. Conclusion Aripiprozole would have better efficacy and tolerability in the treatment of schizophrenia, and could improve the patients social function and attitude to taking drug.