奥氮平与利培酮在精神分裂症治疗中疗效差异分析

Comparison of the efficacy of olanzapine and risperidone in the treatment of schizophrenia

目的:比较奥氮平与利培酮在治疗精神分裂症中的效果差异。方法:选取2017年1月至2018年2月上海市嘉定区精神卫生中心收治的精神分裂症患者为研究对象,分别接受奥氮平、利培酮药物干预,对比2组患者治疗前后阳性与阴性症状量表(PANSS)评分,治疗有效率和不良反应发生情况。结果:共纳入86位研究对象,所有患者用药依从性较好,仅在第6个月时利培酮组有1位患者失访。治疗后1、3和6个月时奥氮平组的阳性症状、阴性症状、一般精神病理评分均显著低于利培酮组(均P<0.05);利培酮组的总体有效率为93. 75%,奥氮平组的总体有效率为92.65%,2组患者治疗总体有效率无显著差异(P=0.09);奥氮平组发生体质量增加、嗜睡、头痛头晕、心动过速、锥体外系反应和便秘的次数显著高于利培酮组(均P<0. 05)。结论:奥氮平和利培酮在治疗精神分裂症上的疗效相当,但是奥氮平的体质量增加等不良反应的发生率相对更高,有待后续大样本和多中心的研究进一步证实。

Objective This study was designed to compare the effects of olanzapine and risperidone in the treatment of schizophrenia.Methods Patients with schizophrenia admitted to Shanghai Jiading District Mental Health Center from January 2017 to February 2018 were selected as study subjects.They were treated with olanzapine and risperidone respectively,and the positive and negative symptoms before and after treatment,PANSS scores,treatment effectiveness and occurrence of adverse reactions were observed and compared.Results A total of 86 patients were included.All patients had better medication adherence,and only one patient in the risperidone group was lost to follow-up at the sixth month.At 1 month,3 months and 6 months after treatment,the positive,negative and general psychopathological scores of olanzapine group were significantly lower than those of risperidone group (all P<0.05). For risperidone group,the overall effective rate was 93.75%,and the total effective rate was 92.65% in the olanzapine group.There was no significant difference in overall efficacy between the two groups (P=0.09). The olanzapine group experienced increased body mass,lethargy,headache,dizziness,and heartbeat.The number of tachycardia,extrapyramidal reactions and constipation was significantly higher than that of risperidone (all P< 0.05). Conclusion The efficacy of olanzapine and risperidone in the treatment of schizophrenia is comparable,but the incidence of adverse reactions such as increased body weight of olanzapine is relatively higher,and it needs to be further confirmed by subsequent large-sample and multi-center studies.