喹硫平与奋乃静治疗脑血管病所致精神障碍对照研究

Quetiapine and perphenazine in the treatment of mental disorders due to cerebrovascular disease

目的探讨喹硫平与奋乃静治疗脑血管病所致精神障碍的临床疗效和安全性。方法将60例脑血管病所致精神障碍患者随机分为研究组和对照组各30例,研究组口服喹硫平,对照组口服奋乃静治疗,观察8周。于治疗前及治疗第2、4、8周末采用阳性与阴性症状量表(PANSS)、日常生活能力量表(ADL)及副反应量表(TESS)评定临床疗效及不良反应。结果治疗8周末,研究组有效率86.7%,对照组为83.3%,2组比较差异无统计学意义(P>0.05);治疗第2周末起PANSS及ADL总分和各因子分均较治疗前显著下降(P<0.05或0.01),并随着治疗时间的延续呈持续性下降;同期2组间比较差异无统计学意义(P均>0.05);2组不良反应均较轻微,研究组主要表现为嗜睡、直立性低血压等,对照组主要表现为锥体外系反应、口干、便秘等。结论喹硫平治疗脑血管病所致精神障碍疗效与奋乃静相当,安全性高,依从性好,可作为治疗脑血管病所致精神障碍的首选药物。

Objective To explore the clinical efficacy and safety of quetiapine and perphenazine in the treatment of mental disorders due to cerebrovascular disease. Methods Sixty patients with mental disorders due to cerebrovascular disease were randomly divided into study group and control group, each 30 cases, respectively took quetiapine and perphenazine for 8 weeks. The both were assessed by the positive and negative syndrome scale （PANSS）, activities of daily living （ADL）and side effects scale （TESS） respectively before treatment and after treatment with 2,4,8 weeks. Results After 8-week treatment,the effective rate of study group was 86.7% and that of control group was 83.3%, there was no significant difference between the two groups（P〈0.05） ; Since the end of second week, ADL and PANSS total scores and each factor score were significantly decreased compared with before treatment （P〈0. 05 or 0.01）, and with the extension of treatment time, the scores continually declined; Over the same period, the both groups scores showed no significant difference （P〉0. 05） ; Their adverse reactions were all minor, the performances of study group were mainly lethargy, orthostatic hypotension and so on, the control group showed mainly extrapyramidal symptoms, dry mouth, constipation etc. Conclusion The effect of quetiapine and perphenazine in the treatment of mental disorders due to cerebrovascular disease are quite, high safety, good compliance. Therefore, quetiapine can be used as the preferred drugs in the treatment of mental disorders due to cerebrovaseular disease.