氯氮平与氯丙嗪治疗维持期精神分裂症患者的临床疗效及安全性比较

Comparison of Clinical Efficacy and Safety of Clozapine and Chlorpromazine in the Treatment of Patients with Maintenance Schizophrenia

目的研究氯氮平与氯丙嗪治疗维持期精神分裂症(SP)患者的临床疗效及安全性。方法以2019年1月-2020年2月佳木斯精神病人福利院接收的70例维持期SP患者为研究对象,采用随机数字表法进行分组,一组应用氯氮平治疗(氯氮平组),另一组采用氯丙嗪治疗(氯丙嗪组),各35例。比较两组阳性和阴性症状量表(PANSS)评分、病情康复情况[简明精神病评定量表(BPRS)、住院精神病人康复疗效评价量表(IPROS)]、临床疗效及不良反应。结果两组治疗后PANSS评分均低于治疗前,且氯氮平组PANSS阴性量表评分低于氯丙嗪组(P<0.05);两组治疗后阳性量表、一般精神病理量表比较,差异无统计学意义(P>0.05);两组治疗后BPRS、IPROS评分均有下降(P<0.05),但组间差异无统计学意义(P>0.05);两组治疗有效率比较,差异无统计学意义(P>0.05);氯氮平组不良反应发生率低于氯丙嗪组(P<0.05)。结论氯氮平与氯丙嗪治疗维持期SP疗效相当,二者均可有效改善患者阳性症状,康复效果理想,但氯氮平对阴性症状的改善作用更佳,且不良反应相对较少。

Objective To study the clinical efficacy and safety of clozapine and chlorpromazine in the treatment of patients with maintenance schizophrenia(SP).Methods From January 2019 to February 2020,70 SP patients in maintenance period received by Jiamusi Psychiatric Welfare Hospital were selected as the research objects.They were divided into two groups by random number table method,one group was treated with clozapine(clozapine group),the other group was treated with chlorpromazine(chlorpromazine group),with 35 cases in each group.The Positive and Negative Syndrome Scale(PANSS)scores,disease rehabilitation[Brief Psychiatric Rating Scale(BPRS),Inpatient Psychiatric Rehabilitation Outcome Scale(IPROS)],clinical efficacy and adverse reactions were compared between the two groups.Results The PANSS scores of the two groups after treatment were lower than those before treatment,and the PANSS negative scale score of the clozapine group was lower than that of the chlorpromazine group(P<0.05),while there was no significant difference in the positive scale and general psychopathological scale between the two groups after treatment(P>0.05).The BPRS and IPROS scores of the two groups decreased after treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the effective rate between the two groups(P>0.05).The incidence of adverse reactions in clozapine group was lower than that in chlorpromazine group(P<0.05).Conclusion Clozapine and chlorpromazine have similar efficacy in the treatment of SP during maintenance period.Both of them can effectively improve the positive symptoms of patients,and the rehabilitation effect is ideal.However,clozapine has a better improvement effect on negative symptoms,and has relatively few adverse reactions.