哌罗匹隆与维思通治疗64例慢性精神分裂症疗效及不良反应对照研究

Perospirone and risperidone in treating 64 cases of chronic schizophrenia efficacy and adverse reactions of case-control study

目的比较哌罗匹隆与维思通治疗慢性精神分裂症的疗效及不良反应。方法分别用哌罗匹隆和维思通治疗慢性精神分裂症64例,疗程8周。采用中国修订韦氏成人智力量表(WAlS-RC)、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)及简易智力状况检查量表(MMSE)于治疗前及治疗结束后进行认知功能评定,用阳性与阴性症状量表(PANSS)和不良反应量表(TESS)评定药物的疗效和不良反应,同时检测两组的血清泌乳素、体重等。结果治疗8周后哌罗匹隆组显效率为60.5%,总有效率为90.7%;维思通组分别为58.1%和88.3%,两组间比较差异无显著性(P>0.05)。哌罗匹隆组的肌强直、震颤、静坐不能等锥体外系反应发生率低于维思通组,差异有显著性(P<0.05);闭经、泌乳、体重增加、月经推迟的发生率明显少于维思通组,差异有极显著性(P<0.01);哌罗匹隆组血清泌乳素水平治疗前后无明显改变,而维思通组则显著高于治疗前。治疗8周后两组的WAIS-RC、WMS、WCST及MMSE评分均显著高于治疗前,差异有显著性。结论哌罗匹隆与维思通治疗慢性精神分裂症患者均有良好疗效,能有效的改善慢性精神分裂症患者的认知功能,哌罗匹隆组的不良反应低于维思通组,更适于年轻女性及肥胖的精神分裂症患者。哌罗匹隆具有疗效和安全性好、不良反应小、改善率高、依从性好,全面提高患者生活质量的特点。

Objective To compare the perospirone and risperidone in the treatment of chronic schizophrenia curative effect and adverse reaction. Methods Using perospirone and risperidone in the treatment of chronic schizophrenia in 64 patients, treated for 8 weeks. The Chinese revised Wechsler A- dult Intelligence Scale （WA1S -- RC）, Wechsler Memory Scale （WMS）, Wisconsin Card Sorting Test （WCST） and mini--mental state examination scale （MMSE） before and after the treatment and after the evaluation of cognitive function, using the positive and negative symptom scale （PANSS） and adverse re- action scale （TESS） assessment of drug efficacy and adverse reactions, the simultaneous detection of two serum prolactin, weight etc. Results After 8 weeks of treatment Houpai Pilong group, the effective rate was 60.5%, total effective rate was 90.7%; risperidone group were 58.1% and 88.3%, the differ- ence between the two groups was not significant （P 〉 0.05）. Perospirone group myotonia, tremor, aka- thisia, extrapyramidal reaction rates below the risperidone group, there was significant difference （P 〈0.05） ; amenorrhea, lactation, weight gain, delayed menstruation was significantly less than risperidone group, the difference was significant （P 〈 0.01） ; perospirone group serum prolactin level no significant change before and after treatment, whereas risperidone group were significantly higher than those before treatment. After 8 weeks treatment in two groups of WAIS, RC, WMS, WCST and MMSE scores were significantly higher than those before treatment, there were significant differences. Conclusions Pero- spirone and risperidone in the treatment of chronic schizophrenia patients have good curative effect, can effectively improve the chronic schizophrenia cognitive function, perospirone group the adverse drug re- action below the risperidone group, more suitable for young women and obese patients with schizophreni- a. Perospirone is effieat and has good safety, little adverse reaction, high recovery rate, better compli- ance, and comprehensively improve the quality of life of patients with characteristics.