喹硫平与氯丙嗪治疗精神分裂症攻击行为对照研究

A control study of quetiapine vs. chloropramazine in aggres-sive behavior of schizophrenia

目的探讨喹硫平治疗精神分裂症攻击行为的临床疗效及安全性。方法将94例精神分裂症患者随机分为两组，每组47例，研究组口服喹硫平治疗，对照组口服氯丙嗪治疗，观察6周。于治疗前及治疗1周、2周、4周、6周末采用简明精神病量表评定精神症状，攻击行为观察量表评定攻击行为，副反应量表评定不良反应。结果治疗后两组简明精神病量表总分、攻击行为观察表评分及攻击行为发生频次均较治疗前显著性下降（P〈O．01）；研究组攻击行为观察量表评分、攻击行为发生总频次及不能控制的大发脾气、猜疑事事对己不利、敌对因子发生频次均显著低于对照组（P〈O．05或0．01）。研究组不良反应发生率为14．9％，对照组为38．3％，研究组显著低于对照组（x^2=6．59，P〈O．05）。结论喹硫平治疗精神分裂症疗效显著，与氯丙嗪相当，但对攻击行为症状的改善优于氯丙嗪，安全性更高，依从性更好。

Objective To explore the clinical efficacy and safety of quetiapine in aggressive behavior of schizophrenia. Methods Ninety-four schizophrenics were randomly divided into two groups of 47 patients each. Research group took orally quetiapine and control group did chloropramazine for 6 weeks. Mental symptoms were assessed with the Brief Psychiatric Rating Scale （BPRS）, aggressive behaviors with the Aggressive Behavior Observation Scale （ABOS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before and at the end of the 1^St, 2^nd, 4th and 6th week treatment. Results After treatment, the BPRS total scores, ABOS scores and the frequency of aggressive behavior of both groups lowered more significantly compared with pretreatment （P〈0.01） ; compared with the control group, the research presented significantly lower ABOS score, total frequency of aggressive behavior and frequency of uncontrollable rage, suspicion of everything unfavorable to oneself and hostility （P〈0.05 or 0.01）. The incidence of adverse reaction was significantly lower in the research than in the control group（14.9% vs. 38.3%, x^2 =6.59,P〈0.05）. Conclussion Quetiapine is as effective as chloropramazine on schizophrenia, but the former has the advantage of the latter in improving attack behavior, safety and compliance.