奥氮平与氟哌啶醇改善老年精神分裂症精神症状及认知功能的差异性研究

Difference of Clinical Efficacy and Cognitive Function Between Olanzapine and Haloperidol in Treatment with Senile Schizophrenia

目的探究老年精神分裂症患者应用奥氮平治疗的临床疗效及对认知功能的改善作用。方法选取2013-08/2016-08月在作者医院治疗的74例老年精神分裂症患者为研究对象。采用随机数表法将患者分为研究组(n=37)和对照组(n=37),分别给予奥氮平、氟哌啶醇口服治疗。并于治疗前、治疗4周、治疗8周时采用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估患者精神症状,通过PANSS减分率评定临床疗效,选择威斯康星卡片分类测验(Wisconsin card sorting test,WCST)、韦氏记忆量表(Wechsler memory scale,WMS)评估患者认知功能。结果研究组临床治疗有效率优于对照组,组间比较差异具有统计学意义(P<0.05)。两组治疗前PANSS评分、WCST评分、WMS-MQ评分比较均无统计学意义(P>0.05)。治疗后,两组阳性症状、阴性症状、一般精神病理及总评分较治疗前均显著降低(P<0.05),研究组PANSS评分较对照组降低更明显(P<0.05);WCST各项评分改善优于对照组(P<0.05)。结论老年精神分裂症患者应用奥氮平治疗可改善精神症状,提高临床治疗效果,并可改善老年患者的认知功能,效果优于氟哌啶醇。

Objective To investigate the clinical efficacy and cognitive function of olanzapine in the treatment of se- nile schizophrenia. Methods Seventy-four senile schizophrenia patients in author＇s hospital from August 2013 to August 2016 were selected as the subjects. The patients were divided into Study group （n = 37） and control group （n = 37） by the random number table method. Olanzapine and haloperidol were orally administered, respectively. Positive and negative symptoms scale （PANSS） was used to assess psychiatric symptoms, the reduction rate of PANSS was evaluated the clini- cal efficacy, meanwhile, Wisconsin card sorting test （WCST） and Wechsler memory scale （WMS） were assessed the cogni- tive function before and after 4,8,12 weeks treatment. Results The effective rate of study group was better than that of control group （Z= - 2. 009,P〈0. 05）. No diffenence was found in the PANSS,WCST and WMS^MQ scores between two groups before treatment （P〈0. 05）. After treatment, the positive and negative symptoms, general psychopathology and total scores of two groups were all decreased （P^0. 05）. The PANSS score of study group was significantly lower than that of control group （P〈0. 05）. The WCST score of study group was better than that of control group （P〈0. 05）. Conclusion Olanzapine treatment in senile schizophrenia can improve mental symptoms and clinical efficacies, and also prove the cognitive function of elderly patients. Olanzapine is more eftective than halopendol.