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4种第二代抗精神病药物治疗精神分裂症急性期的临床观察
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| 篇名： | 4种第二代抗精神病药物治疗精神分裂症急性期的临床观察 |
| TITLE： | |
| 摘要： | 目的：考察4种第二代抗精神病药物治疗精神分裂症急性期的临床疗效及不良反应。方法：将159例精神分裂症患者按照随机数字表法分为利培酮组（40例）、奥氮平组（40例）、阿立哌唑组（39例）和齐拉西酮组（40例），每组患者按常规用法用量给予对应的药物，进行为期6周的临床研究。治疗前和治疗2、4、6周末采用阳性与阴性症状量表对各组患者的精神状况进行评定；同时进行血糖、血脂、泌乳素等代谢和生物学指标检测；并采用锥体外系副反应量表、静坐不能评定量表、精神性不良反应量表评定不良反应。结果：共计137例患者完成研究。利培酮组和奥氮平组对精神症状的控制，尤其是对阳性症状的控制起效快于阿立哌唑组和齐拉西酮组，差异有统计学意义（P＜0.05）。治疗后，奥氮平组患者的体质量指数和腹围增加数明显大于其他3组，差异均有统计学意义（P＜0.05）；该组患者的低密度脂蛋白也明显增高，与齐拉西酮组和阿立哌唑组比较，差异均有统计学意义（P＜0.05）；利培酮组患者的泌乳素水平明显高于其他3组，阿立哌唑组患者的泌乳素水平明显低于其他3组，差异均有统计学意义（P＜0.05）。4种药物的不良反应多数为轻度或中度，对症处理后大多可缓解。结论：4种第二代抗精神病药物对精神分裂症急性期精神症状的控制疗效相当，其中利培酮、奥氮平控制阳性症状的起效时间较早，与糖脂代谢和泌乳素有关的不良反应也出现较多；阿立哌唑、齐拉西酮的不良反应相对较少，患者的耐受性较好。用药时应全面考虑各种因素，制订个体化的治疗方案。 |
| ABSTRACT： | OBJECTIVE： To investigate clinical efficacy and adverse reactions （ADRs） of 4 kinds of the second-generation antipsychotic drugs in the treatment of acute phase of schizophrenia. METHODS： 159 patients with schizophrenia were randomly divided into risperidone group （40 cases）， olanzapine group （40 cases）， aripiprazole group （39 cases） and ziprasidone group （40 cases）. All groups were given routine dosage of relevant medicine by routine usage for 6 weeks. Mental status of patients were measured by PANSS before treatment and after 2， 4 and 6 weeks of treatment. At the same time， blood glucose， blood lipid， prolaction and other metabolic and biological indicators were all detected. RSESE， BARS and UKU were adopted to evaluate ADR. RESULTS： A total of 100 patients completed the study. Compared with aripiprazole group and ziprasidone group， risperidone and olanzapine inhibited symptom more rapidly， with statistical significance （P＜0.05）. After treatment， body mass index and abdominal circumference of olanzapine group were significantly higher than those of other 3 groups， with statistical significance （P＜0.05）. Low density lipoprotein of olanzapine group was increased significantly， there was statistical significance compared to ziprasidone group and aripiprazole group （P＜0.05）. Prolactin level of risperidone group was significantly higher than those of other 3 groups， while that of aripiprazole group was significantly lower than those of other 3 groups， with statistical significance （P＜0.05）. ADRs of 4 drugs were mild or moderate， most of whom could be alleviated by symptomatic treatment. CONCLUSIONS： In the treatment of acute phase schizophrenia， 4 drugs of the second-generation have similar curative effect in symptoms control， among which risperidone and olanzapine inhibit positive symptom more rapidly while more ADRs that related to lipid and glucose metabolism and prolactin also show. Aripiprazole and ziprasidone induce less ADRs relatively， and patients show better tolerability. Physicians should consider all kinds of factors in drugs selection， and make individualized treatment plan. |
| 期刊： | 2016年第27卷第20期 |
| 作者： | 赵晶媛，黄光彪，顾小静，艾小青，杨淑珍，华婷婷，吕路线 |
| AUTHORS： | ZHAO Jingyuan，HUANG Guangbiao，GU Xiaojing，AI Xiaoqing，YANG Shuzhen，HUA Tingting，LYU Luxian |
| 关键字： | 第二代抗精神病药物；精神分裂症；急性期；利培酮；奥氮平；阿立哌唑；齐拉西酮；临床疗效；不良反应 |
| KEYWORDS： | The second-generation antipsychotic drugs； Schizophrenia； Acute phase； Risperidone； Olanzapine； Aripiprazole； Ziprasidone； Clinical efficacy； Adverse reactions |
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