喹硫平与奥氮平治疗癫痫性精神障碍的对照研究

Comparative study of quetiapine and olanzapine in the treatment of mental disorder caused by epilepsy

目的探讨喹硫平与奥氮平治疗癫痫性精神障碍的效果及安全性,为癫痫性精神障碍的治疗提供参考。方法选取2015年1月-2018年1月佛山市第三人民医院收治的符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)诊断标准的癫痫性精神障碍患者80例,按随机数字表法分为对照组与观察组各40例。观察组给予喹硫平治疗,对照组给予奥氮平治疗;疗程均为6周。于治疗前和治疗后采用阳性和阴性症状量表(PANSS)与副反应量表(TESS)评定疗效和安全性。结果治疗6周后,两组PANSS总评分及各分量表评分均低于治疗前,差异均有统计学意义(P均<0.01);观察组PANSS总评分及各分量表评分均低于对照组,差异均有统计学意义(t=6.75~11.43,P均<0.01);两组总有效率比较差异无统计学意义(χ~2=0.22,P=0.637);观察组不良反应发生率低于对照组,差异有统计学意义(χ~2=3.68,P<0.05)。结论喹硫平与奥氮平均能改善癫痫性精神障碍患者的精神症状,但喹硫平疗效优于奥氮平且安全性更好。

Objective To explore the efficacy and safety of quetiapine and olanzapine in the treatment of mental disorder caused by epilepsy,and to provide references for the treatment of it.Methods 80 subjects were recruited from The Third People's Hospital of Foshan city during January 2015 to January 2018.The diagnosis mental disorder caused by epilepsy were given according to the Chinese Classification and Diagnostic Criteria of Mental Disease,third edition(CCMD-3).According to the random number table method,80 cases were divided into control group and observation group.Both the observation group treated with quetiapine and the control group treated with olanzapine received 6 weeks medicine.Before and after treatment,efficacy and safety were assessed with Positive and Negative Syndrome Scale(PANSS)and Treatment Emergent Symptom Scale(TESS).Results After 6 weeks of treatment,the total PANSS score and scores of each subscale of the two groups were lower than those before treatment(all P<0.01).Comparison of total PANSS score and scores of each subscale between the two groups showed that the observation group was lower than the control group(t=6.75~11.43,all P<0.01).The difference of total effective rate between two groups was not statistically significant(χ2=0.22,P=0.637).The difference of the adverse events incidence between two groups was statistically significant(χ2=3.68,P<0.05).Conclusion On average,both quetiapine and olanzapine can improve the mental symptom of patients with mental disorder caused by epliepsy,but quetiapine is more effective and safer than olanzapine.