奎硫平与阿立哌唑治疗老年期首发精神分裂症临床分析

A Clinical Analysis of Quetiapine and Aripiprazole Treatment of Senile Episode Schizophrenia

目的:观察奎硫平与阿立哌唑治疗老年期首发精神分裂症的临床疗效和安全性。方法:将我院收治的老年期首发精神分裂症患者108例随机分为A组和B组,每组54例,A组患者口服奎硫平,起始剂量50 mg/d,最大剂量450 mg/d,平均(327.8±75.8)mg/d;B组患者口服阿立哌唑,起始剂量5 mg/d,最大剂量30 mg/d,平均(21.5±3.6)mg/d;疗程12周。于治疗前及治疗后2、4、8、12周末应用阳性症状和阴性症状量表(PANNS)评价临床疗效,应用副反应量表(TESS)评价药物不良反应。结果:①治疗12周后,A组痊愈19例(35.2%),显效15例(27.8%),好转15例(27.8%),无效5例(9.3%),显效率为63.0%,有效率为90.7%;B组痊愈20例(37.0%),显效14例(25.9%),好转15例(27.8%),无效5例(9.3%),显效率为70.0%,有效率为90.7%,两组比较无统计学差异(P>0.05)。②治疗2周末开始两组PANNS量表各项得分及总分均有所降低,与治疗前比较有统计学意义(P<0.05);两组组间比较PANNS量表各项得分及总分无统计学差异(P>0.05)。③A组头晕、口干、食欲减退多于B组,B组失眠、恶心、呕吐、心动过速多于A组(P<0.05)。结论:奎硫平与阿立哌唑治疗老年首发精神分裂症不良反应虽有异同,但两种药物临床疗效相当,适合老年首发精神分裂症的治疗。

Objective： To analyse the clinical efficacy and safety of quetiapine and aripiprazole treatment in elderly senile episode schizophrenia patients. Methods： The 108 cases of elderly senile episode schizophrenia patients in our hospital were randomly divided into group A and group B, n -54 cases, the patients in the group A took quetiapine which starting dose was 50 rag/d, the maximum dose was 450 mg/d, the average dose was （327.8± 75.8） mg/d; the patients in the group B took aripiprazole which initial dose was 5mg/d, the maximum dose was 30 mg/d, average dose was （21.5± 3.6） mg/d; for 12 weeks. After treatment of 2, 4, 8, 12 weeks and before treatment used PANNS to evaluate clinical efficacy, TESS to evaluate adverse drug reactions. Results： ① After 12 weeks of treatment, in group A 19 cases （35.2 %） were cured, 15 cases took effect （27.8 %）, and 15 cases were improved（27.8 %）, and 5 cases took no effect （9.3 %）, markedly effective rate was 63.0 % and efficient rate was 90.7 %; 20 cases in group B （37.0 %） were cured, 14 cases took effect （25.9 %）, 15 cases were improved （27.8 %）,and 5 cases were ineffective （9.3 %）, markedly effective rate was 70.0 %, the effective rate of 90.7 %. There was no statistically significant difference （P〉 0.05）. （~） After treatment of two weeks, two groups PANNS scale of the score and total score were reduced compared with before treatment, and the difference was statistically significant （P 〈0.05）; The score and total score of PANNS scale between the two groups had significant difference （P〉0.05）. （~） In the group A, the symptoms of dizziness, dry mouth, loss of appetite was more than those in the group B; In the group B, the symptoms of insomnia, nausea, vomiting, tachycardia was more than those in the group A （P 〈0.05）. Conclusion： Quetiapine and Aripiprazole in treatment of elderly first-episode schizophrenia had different adverse reactions, but the clinical efficacy of two drugs is quite suitable for the treatment of elderly schizophrenia.