四种非典型抗精神病药物治疗精神分裂症的疗效观察

Study on the therapeutic effect and the adverse reaction in treatment of schizophrenia with quadri-species atypical antipsychotics

目的比较阿立哌唑、奎硫平、利培酮、奥氮平四种常用的非典型抗精神病药物对精神分裂症患者的疗效及不良反应的差异。方法将入组的120例精神分裂症患者随机分为阿立哌唑组、奎硫平组、利培酮组、奥氮平组各30例,在入组前和治疗后2、4、6、8周,采用阳性和阴性症状量表(PANSS)评估疗效,以副反应量表(TESS)评估不良反应,同时观察血清泌乳素、体重的变化。结果治疗8周后四组患者的PANSS分均有明显变化,与治疗前相比差异有统计学意义(t分别=9.86、10.68、11.22、8.77,P均<0.05),但四组间比较PANSS评分,除治疗2周后奎硫平优于其他组(F=3.07,P<0.05),治疗4、6、8周后差异无统计学意义(F分别=0.70、1.05、0.78,P均>0.05)。利培酮及奥氮平治疗组比阿立哌唑和奎硫平治疗组血清泌乳素增高显著(F=4.04,P<0.05),同时引起性功能障碍和女性月经紊乱、闭经;奥氮平体重增加更多(F=2.94,P<0.05)。结论四种非典型抗精神病药物对精神精神分裂症患者疗效肯定,不良反应各异。

Objective To compare the differences of the therapeutic effect and the adverse reaction of schizophrenic therapy with commonly used quadri-species atypical antipsychotics： aripirazole,quetiapine,risperidone,olanzapine. Methods A total of 120 schizophrenia patients were randomly divided into 4 groups （aripirazole group,quetiapine group, risperidone group,olanzapine group）.The positive and negative syndrome scale （PANSS）, treatment emergent symptom scale （TESS）, change of blood serum prolactin and body weight, both in prior-treatment and post-treatment 2,4,6,8 weeks were evaluated. Results After 8 weeks, four groups had significant changes in PANSS compared with that before treatment （t=9.86,10.68,11.22,8.77, P〈0.05）;the differences of four PANSS score were not significant 4,6,8 weeks after treatment （F=0.70,1.05,0.78,P〉0.05）. Risperidone and olanzapine groups caused a more significant increase in serum prolactin（F=4.04,P〈0.05）than the aripiprazole and quetiapine groups, and also caused sex disorders and female menstrual disorder,amenorrhea;while olanzapine group induced more body weight increase （F=2.94,P〈0.05）. Conclusions The therapeutic effect of quadri-species atypical antipsychotics in schizophrenia is effective. The adverse reaction is different.