氯氮平与舒必利治疗老年精神分裂症阳性症状的观察

Comparative analysis of efficacy and safety of clozapine versus sulpiride in the treatment of positive symptoms of senile schizophrenia

目的观察氯氮平与舒必利对老年性精神分裂症阳性症状的疗效及安全性对比分析。方法选择74例阳性症状为主的老年精神分裂症患者,随机分为对照组及观察组各37例。对照组给予舒必利治疗,观察组给予氯氮平治疗,观察2组患者的疗效、阳性症状评分及不良反应。结果 2组有效率比较,观察组优于对照组(P<0.05)。2组治疗前在幻觉、妄想、行为怪异、阳性思维障碍等阳性症状和阳性症状总分比较,差异均无统计学意义(P>0.05),2组在治疗后幻觉、妄想、行为怪异、阳性思维障碍等阳性症状和阳性症状总分比较,观察组均优于对照组(P<0.05)。2组在白细胞减少、流涎、心电图异常及血糖升高方面不良反应比较,对照组明显少于观察组(P<0.05),在静坐不能、泌乳闭经不良反应比较,观察组少于对照组(P<0.05),在嗜睡、便秘不良反应比较,2组差异无统计学意义(P>0.05)。结论氯氮平改善精神分裂症患者的阳性症状效果好,有效率高,但氯氮平在白细胞减少、流涎、心电图异常及血糖升高方面不良反应较多,临床应用对于有以上特殊情况的患者应该避免应用。

Objective To observe the comparative analysis of efficacy and safety of clozapine versus sulpiride in the treatment of positive symptoms of senile schizophrenia.Methods All of 74 senile schizophrenia patients mainly with positive symptoms were randomly divided into control group and observation group,and each group had 37 cases.Patients in control group were given by sulpiride and patients in observation group were treated by clozapine.Then the clinical efficacy,positive-symptom scores and adverse reactions of the two groups were observed.Results The observation group showed better effective rate than the control group（P0.05）.There were no significant differences between the two groups before treatment in terms of hallucinations,delusions,strange behavior,positive thought disorder,and total scores of positive symptoms（P0.05）,all of which in the observation group were significantly superior to those in the control group（P0.05）.The occurrence rates of adverse reactions mainly including leucopenia,salivation,ECG abnormality and increased blood glucose in the control group were significantly lower than those in the observation group（P0.05）,but the occurrence rates of akathisia and lactation amenorrhea reaction in the observation group were higher than those in the control group（P0.05）,and there were no significant differences between the two groups as for drowsiness and constipation（P0.05）.Conclusion Clozapine has a good effect on improving the positive symptoms of schizophrenia with high clinical efficacy,but can generate many adverse reactions mainly including leucopenia,salivation,ECG abnormality and increased blood glucose.So patients with above-mentioned reactions should avoid taking clozapine.