奥氮平和利培酮治疗精神分裂症的疗效和安全性比较

Comparative study on olanzapine and risperidone in treatment of schizophrenia

目的比较奥氮平和利培酮治疗精神分裂症的疗效及安全性。方法 128例精神分裂症患者随机分为奥氮平组(64例)和利培酮组(64例),治疗时间为8周。应用阳性和阴性症状量表(PANSS)和不良反应量表(TESS)评定两种药物的临床疗效和不良反应。结果奥氮平组在治疗2周末、4周末、8周末PANSS总分均小于利培酮组,差异有统计学意义(t=-2.223,-2.927,-2.339;P<0.05)。在8周的治疗过程中,两组患者PANSS得分均随着时间的延长而呈下降趋势(P<0.05)。奥氮平组有效率为95.31%,利培酮组有效率为89.06%,两组临床疗效差异无统计学意义(χ2=1.736;P>0.05)。奥氮平组肝功能异常和体质量增加高于利培酮组,差异有统计学意义(χ2=4.571,4.827;P<0.05)。利培酮组肌强直、震颤、静坐不能高于奥氮平组,差异有统计学意义(χ2=5.885;P<0.05)。结论奥氮平和利培酮对精神分裂症均具有较好的疗效,奥氮平较利培酮起效快;两药均较安全,但奥氮平可导致肝功能异常和体质量增加。

Objective To compare the efficacy and safety of olanzapine and risperidone in the treatment of schizophrenia. Methods A total of 128 patients with schizophrenia were randomly divided into olanzapine group（64 cases） and risperidone group （ 64 cases） for 8 weeks treatment. The efficacy was evaluated by positive and negative syndrome （ PANSS）, and the side effects by treatment emergent symptoms scale （TESS）. Results The PANSS total scores in olanzapine group were lower than in rispcridone group at the end of the second week, the fourth week and the eighth week, with statistically significant differences （ t = - 2. 223, - 2. 927, -2. 339 ;P 〈 0.05）. During 8 weeks treatment, in the two groups of patients, PANSS scores showed downward trend over time （P 〈 0.05 ）. The effective rate in olanzapine group was 95.31% and in risperidone group was 89.06% ,there was no significant difference in the efficacy between the two groups（x2 = 1. 736;P 〉0.05）. The liver dysfunction and weight gain in olanzapine group were higher than in risperidone group, the difference was statistically significant （X2 = 4.571,4.827;P 〈 0.05 ）. The myotonia, tremor and akathisia in risperi- done group were higher than in olanzapine group,the difference was statistically significant（x2 --5.885 ;P 〈0.05）. Condusions Olanzapine and risperidone in the treatment of schizophrenia have a better efficacy, olanzapine work early than risperidone, they are all safe though olanzapine can lead to liver dysfunction and body mass increase as risperidone can lead to extrapyramidal symptoms.