奥氮平与氯氮平治疗难治性精神分裂症的对照研究

Research on Comparison of Olanzapine and Clozapine in Treatment of Treatment-resistant Schizophrenia

目的比较奥氮平与氯氮平治疗难治性精神分裂症的疗效与安全性。方法方便择取该院2011年5月—2014年12月收治的110例入组患者为研究对象,符合ICD-10精神、难治性精神分裂症诊断标准,将患者随机分为两组,奥氮平组和氯氮平组,每组55例,分别给予奥氮平及氯氮平治疗8周,在基线、治疗2周、4周、8周,对疗效评分采用PANSS,即阳性与阴性症状量表,对治疗中的不良反应以TESS,即副反应量表评定。结果治疗8周后,奥氮平组显效率27.3%,有效率60.0%,氯氮平组显效率30.9%,有效率63.6%,两组有效率比较差异无统计学意义(P>0.05);奥氮平组不良反应发生率16.4%,氯氮平组为29.1%,氯氮平组药物不良反应发生率明显高于奥氮平组,不良反应发生率的差异有统计学意义(P<0.05)。结论奥氮平与氯氮平治疗难治性精神分裂症的疗效相当,但不良反应较小,耐受性较好。

Objective To compare the curative effect and safety of olanzapine and clozapine in treatment of treatment-resistant schizophrenia.Methods 110 cases of patients with treatment-resistant schizophrenia in our hospital from May 2011 to December 2014 were convenient selected and randomly divided into two groups with 55 cases in each,respectively treated with olanzapine and clozapine for eight weeks,and the curative effect was marked by PANSS at baseline,2-week,4-week and 8-week after treatment namely positive and negative symptoms scale,and the adverse reactions in treatment was evaluated by TESS namely side effect scale.Results After 8-week treatment,the differences in the markedly effective rate and effective rate between the olanzapine group and clozapine group had no statistical significance（27.3%,30.9% vs 60.0%,63.6%）（P〈0.05）,the incidence rate of adverse reactions in the clozapine group was obviously higher than that in the olanzapine group,（16.4% vs 29.1%）,（P〈0.05）.Conclusion The curative effect of olanzapine and clozapine in treatment of treatment-resistant schizophrenia is equivalent with few adverse reactions and good tolerance.