阿立哌唑与奥氮平治疗精神分裂症阴性症状的疗效

Efficacy of aripiprazole and olanzapine in the treatment of negative symptoms of schizophrenia

目的评价阿立哌唑与奥氮平治疗精神分裂症阴性症状的临床疗效与安全性。方法 60例住院治疗的精神分裂症患者,随机分为2组,每组各30例。研究组口服阿立哌唑治疗,对照组口服奥氮平治疗,观察时间8周。于治疗前及治疗后4、8周采用阳性与阴性症状量表(PANSS)、阴性症状评定量表(SANS)评价其疗效,副反应量表(TESS)及实验室检查评价其安全性。结果阿立哌唑组显效率为76.7%,有效率为93.2%。奥氮平组分别为80.0%和96.7%,2组比较,差异无统计学意义(P>0.05)。治疗后第2周起2组PANSS总分及各因子分均较治疗前有显著下降(P均<0.01),并随治疗时间的延续呈持续性下降,但2组间同期比较,差异无统计学意义(P>0.05)。SANS总分和各因子分均较治疗前显著下降(P<0.05)。2组治疗前催乳素水平比较,差异无统计学意义,治疗后研究组显著低于对照组(P<0.01)。2组不良反应轻微,但研究组体质量增加、嗜睡及泌乳发生率均显著低于对照组(P均<0.05),而静坐不能、失眠发生率研究组显著低于对照组(P<0.05)。结论阿立哌唑与奥氮平在治疗精神分裂症阴性症状方面都具有显著效果且疗效相当,阿立哌唑在体质量增加、嗜睡及泌乳方面的不良反应小于奥氮平。

[Objective] To evaluate clinical efficacy and safety of aripiprazole and olanzapine in the treatment of negative symptoms of schizophrenia.[Methods] 60 inpatients with schizophrenia were randomly divided into two groups,30 cases in each group.The study group was treated with aripiprazole orally,the control group was treated with olanzapine orally,and two groups were observed for 8 weeks.The efficacy was evaluated by the Positive and Negative Syndrome Scale（PANSS） and the Scale for the Assessment of Negative Symptoms（SANS） before treatment,4th and 8th week after treatment.The safety was evaluated by the Treatment Emergent Symptom Scale（TESS） and laboratory examination.[Results] The obvious effective rate and the effective rate of the study group was 76.7% and 93.2% respectively,and that of the control group was 80.0% and 96.7% respectively.There was no significant difference between two groups（P0.05）.The total PANSS scores and factor scores of tow groups had reduced significantly since 2nd week of treatment（all P0.01）,and decreased continuously with increasing of treatment duration,but there was no significant difference between two groups（P0.05）.The total SANS scores and factor scores decreased compared with those before treatment.There was no significant difference in prolactin level before treatment between two groups.After treatment,the prolactin level of the study group was significantly lower than that of the control group（P0.01）.The adverse reactions of two groups were mild,but the incidence rates of weight gain,lethargy and lactation in the study group was significantly lower than those in the control group（all P0.05）,and the incidence rates of akathisia and insomnia in the study group was significantly higher than those in the control group（P0.05）.[Conclusion] Aripiprazole and olanzapine have good clinical efficacy in the treatment of negative symptoms of schizophrenia,and their effects are similar.The adverse reactions in weight gain,lethargy and lactation of aripiprazole are less than those of olanzapine.