齐拉西酮与氟哌啶醇对精神分裂症患者社会功能和生活质量的影响

Effects of ziprasidone vs.haioperidol on social function and quality of life in schizophrenia patients

目的 比较齐拉西酮与氟哌啶醇对精神分裂症患者的社会功能和生活质量的长期影响.方法 将120例精神分裂患者随机分为两组,每组60例,研究组口服齐拉西酮治疗,对照组口服氟哌啶醇治疗.出院后随访12个月.于治疗前及出院后随访3个月、6个月、12个月末采用阳性与阴性症状量表、副反应量表评定临床疗效及不良反应,世界卫生组织生存质量测定量表评定生活质量,社会功能缺陷量表评定社会功能缺陷状况.结果 随访3个月末、6个月末、12个月末,两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（P＜0.01）;同期研究组阴性症状因子分较对照组下降更显著（P＜0.01）.研究组世界卫生组织生存质量测定量表躯体功能、心理功能、独立性、社会关系、生活质量总评因子分均较治疗前显著提高（P＜0.01）,对照组仅独立性因子分较治疗前显著提高（P＜0.01）;同期研究组躯体功能、心理功能、社会关系、生活质量总评因子分均显著高于对照组（P＜0.01）;而社会功能缺陷量表的婚姻职能、社会性退缩、家庭外的社会活动、家庭内活动过少、家庭职能、个人生活自理、对外界的兴趣和关心7个因子分均显著低于对照组（P＜0.05或0.01）.研究组不良反应发生率为13.3%,对照组为41.1%,研究组显著低于对照组（χ2=11.381,P＜0.01）.结论齐拉西酮治疗精神分裂症长期疗效显著,与氟哌啶醇相当,对阴性症状效果更好,改善社会功能、提高生活质量效果更显著,安全性更高.

Objective To compare the long-term influence of ziprasidone vs. haloperidol on social function and quality of life in schizophrenia patients. Methods 120 schizophrenia patients were randomly divided into two groups of 60 ones each, research group took oraaly ziprasidone and control group did haloperidol. They were followed up for 12 months after discharge. Before treatment and at the end of the 3ra, 6th and 12th month follow-up, clinical efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS）, adverse reactions with the Treatment Emergent Symptom Scale （TESS）, quality of life with the World Health Organization Quality of Life 100 （WHOQOL-100） and social disabilities with the Social Disability Screening Schedule （SDSS）. Results At the end of the 3nd, 6th and 12th month follow-up, the total and each factor scores of both groups lowered more signficantly compared with pretreatment （P〈 0.01） ; at the same time, negative symptoms socres lowered more significantly in the research than in the control group （P〈0.01）. Such factors scores of the WHOQOIz100 as physical and psychological func tion, independence, social relation and global impression of quality of life elevated more significantly com pared wirh pretreatment in the research （P〈0.01）, so did only independence in the control group （P〈 0.01） ; such factors scores of the SDSS were significantly lower in the research than in the control group as marital function, social retreating, social activity outside family, lack of movement inside family, family function, personal care, external interest and care （P〈0. 05 or 0. 01）. Incidences of adverse reactions were significantly lower in the research than in the control group （13.3% vs. 41.1%, ;x2= 11. 381,P〈 0. 01）. Conclusion Ziprasidone has a notable long-term efficacy equivalent to haloperidol in schizophrenia, especially in negative symptoms, improves social function and quality of life more significantly and has higher safety.