奥氮平与齐拉西酮治疗精神分裂症对照研究

A control study of olanzapine vs. ziprasidone in the treatment of schizophrenia

目的探讨奥氮平与齐拉西酮治疗精神分裂症的临床疗效及安全性。方法将80例精神分裂症患者随机分为两组，每组40例，研究组口服奥氮平治疗，对照组口服齐拉西酮治疗，观察8周。于治疗前后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。结果治疗后两组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〈O．01），但研究组阴性症状因子分较对照组下降更显著（P〈O．01）；治疗8周末，研究组显效率86．49％、总有效率97．30％，对照组分别为84．21％、94．74％，两组疗效差异无显著性（x^2=0．744，P〉0．05）。研究组不良反应主要表现为体重增加，对照组主要表现为头痛头晕、QT间期延长、震颤等；研究组头痛头晕、QT间期延长发生率显著低于对照组，体重增加发生率显著高于对照组，差异均有显著性（P〈O．05或o．01）。结论奥氮平与齐拉西酮治疗精神分裂症疗效均显著，总体疗效相当，且安全性高，依从性好，但奥氮平改善阴性症状方面显著优于齐拉西酮。

Objective To explore the clinical efficacy and safety of olanzapine vs. ziprasidone in the treatment of schizophrenia. Methods Eighty schizophrenics were randomly divided into two groups of 40 patients each, research group took orally olanzapine and control group did ziprasidone 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 and after treatment. Results The PANSS total and each factor scores of both groups lowered more significantly after treatment compared with pre- treatment （P〈O. 01）, but negatice symptom score lowered more significantly in the research than in the control group （P〈0.01） ; at the end of the 8th week, obvious and total effective rates were 86.49% and 97. 300/oo in the research and 84.21% and 94.74% in the control group, respectively, which showed no sig- nificant differences （x^2=0. 744,P〉0.05）. Adverse reactions were mainly weight gain in the research and headache, dizziness, QT interval prolongation, tremor etc. The incidences of headache, dizziness, QT interval prolongation were significantly lower and that of weight gain higher in the research than in the con trol group, all differences had significance （P〈0.05 or 0.01）. Conclusion Both olanzapine and ziprasidone have an significant efficacy in the treatment of schizophrenia, their total efficacy are equivalent, safety high and compliance good, but the former has the advantage of the latter in improving negative symptoms.