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奥氮平与利培酮治疗精神分裂症患者认知功能的疗效比较
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| 篇名： | 奥氮平与利培酮治疗精神分裂症患者认知功能的疗效比较 |
| TITLE： | |
| 摘要： | 目的：比较奥氮平与利培酮治疗精神分裂症患者认知功能的疗效和安全性。方法：回顾性分析98例精神分裂症患者资料，按治疗方案的不同分为对照组（49）和观察组（49）。正在接受抗精神病药物治疗者，停药洗脱7 d后入组。对照组患者给予利培酮片起始剂量1 mg，口服，每日2次，1周内增加剂量至4～6 mg，每日2次，并维持连续用药6个月。观察组患者给予奥氮平片起始剂量5 mg，口服，每日2次，1周内增加剂量至15～20 mg，每日2次，并维持连续用药6个月。观察两组患者的临床疗效，治疗前后阳性与阴性症状量表（PANSS）评分、韦氏记忆量表（WMS）评分[总记忆商（MQ）评分）]、连线测验（TMT）评分（TMT-A连线时间、TMT-A错误数、TMT-B连线时间、TMT-B错误数评分）、威斯康星卡片分类测验（WCST）评分（完成分类数、持续应答数、总错误数、持续错误数及总正确数），并记录不良反应发生情况。结果：两组患者总有效率比较，差异无统计学意义（93.88％ vs. 97.96％，P＞0.05）。治疗后，两组患者PANSS评分、TMT-A连线时间、TMT-A错误数、TMT-B连线时间、TMT-B错误数、持续应答数、总错误数及持续错误数评分均显著低于同组治疗前，且观察组PANSS评分显著低于对照组，其余指标组间比较差异无统计学意义（P＞0.05）；两组患者MQ评分、完成分类数、总正确数评分均显著高于同组治疗前，差异均有统计学意义（P＜0.05或P＜0.01），但组间比较差异无统计学意义（P＞0.05）。观察组患者体质量增加、嗜睡发生率均显著高于对照组，锥体外系反应、失眠、头痛头晕、口干发生率均显著低于对照组，差异均有统计学意义（P＜0.05）。结论：奥氮平与利培酮治疗精神分裂症的疗效相当，均可有效改善患者认知功能，而奥氮平在改善精神症状方面优于利培酮，但体质量增加、嗜睡发生率较高。 |
| ABSTRACT： | OBJECTIVE： To compare the therapeutic efficacy and safety of olanzapine and risperidone in the treatment of cognitive function in schizophrenia patients. METHODS： The information of 98 patients with schizophrenia were analyzed retrospectively and divided into control group and observation group according to therapy method， with 49 cases in each group. The patients receiving antipsychotic drugs were included in study after 7 d of drug withdrawal and cleaning. Control group received Risperidone tablet with initial dose of 1 mg， twice a day， orally， increasing to 4-6 mg within a week， twice a day， for consecutive 6 months. Observation group was given Olanzapine tablet with initial dose of 5 mg， twice a day， orally， increasing to 15-20 mg within a week， twice a day， for consecutive 6 months. Clinical efficacies of 2 groups were observed， and PANSS， WMS score （MQ score）， TMT score （TMT-A connection time， TMT-A error number， TMT-B connection time， TMT-B error number score）， WCST score （the number of completion classification， the number of sustained response， total number of errors， the number of persistent error and total correct number） were observed before and after treatment. The occurrence of ADR was recorded. RESULTS： There was no statistical significance in total response rate between 2 groups （93.88％ vs. 97.96％，P＞0.05）. After treatment， PANSS score， TMT-A connection time， TMT-A error number， TMT-B connection time， TMT-B error number， sustained response number， total error number and persistent error number scores in 2 groups were significantly lower than before treatment； PANSS score of observation group was significantly lower than that of control group；there was no statistical significance in other indexes betwee 2 groups. MQ score， the number of completion classification and total correct number score of 2 groups were significantly higher than before treatment， with statistical significance （P＜0.05 or P＜0.01）；but there was no statistical significance between 2 groups（P＞0.05）. The incidence of weight gain and lethargy in observation group was significantly higher than control group， and the incidence of extrapyramidal reaction， insomnia， headache， dizziness and dry mouth were significantly lower than control group， with statistical significance （P＜0.05）. CONCLUSIONS： Therapeutic efficacy of olanzapine is similar to that of risperidone in the treatment of schizophrenia. Both of them can effectively improve cognitive function. Olanzapine is better than risperidone in improving psychiatric symptoms， but it increases the incidence of body weight gain and lethargy. |
| 期刊： | 2017年第28卷第36期 |
| 作者： | 王莹，边艳辉，江芮 |
| AUTHORS： | WANG Ying，BIAN Yanhui，JIANG Rui |
| 关键字： | 精神分裂症； 奥氮平； 利培酮； 精神症状； 认知功能； 疗效；安全性 |
| KEYWORDS： | Schizophrenia； Olanzapine； Risperidone； Psychiatric symptoms； Cognitive function； Therapeutic efficacy； Safety |
| 阅读数： | 791 次 |
| 本月下载数： | 7 次 |
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