喹硫平和利培酮治疗伴攻击行为精神分裂症对照研究

目的:探讨两种药物对伴攻击行为精神分裂症的疗效和安全性.方法:将40例符合ICD-10精神分裂症诊断标准,且既往有冲动攻击行为史,入院后1周内再次发生冲动攻击行为,修订版外显攻击行为量表(MOAS)最高加权总分≥5分的患者随机分为两组,分别给予喹硫平和利培酮治疗 8周.于治疗前和治疗后2、4、6、8周末采用PANSS、MOAS评定临床疗效,副反应量表(TESS)评定不良反应.结果:治疗8周后,两组疗效相当(P＞0.05),第2周末两组间治疗后MOAS加权总分喹硫平组低于利培酮组,差异有统计学意义(t=2.203,P＜0.05);两组不良反应发生率差异有统计学意义(x2=4.912,P＜0.05),不良反应中肌张力增高和震颤的发生率喹硫平组均低于利培酮组,差异均有统计学意义(x2=3.906,P＜0.05;x2=4.800,P＜0.05).结论:喹硫平和利培酮治疗伴攻击行为精神分裂症总疗效相当,但喹硫平能较快控制攻击行为提高治疗依从性,且不良反应较少,安全性较高.

Control study of Quetiapine and Risperidone in the treatment of schizophrenia with aggressive behavior

Objective:To compare efficacy and safety of Quetiapine and Risperidone in the treatment of schizophrenia with aggressive behavior.Methods:A total of 40 patients met the criteria of ICD-10 for schizophrenia with aggressive behavior and raings on Modified Overt Aggression scale(MOAS≥5).All the cases were randomly assigned to two group treated with quetiapine or risperidone for 8 weeks.The Positive and Negative Symptoms Scale(PANSS) and MOAS and Treatment Emergent Symtoms Scale(TESS) were used to evaluate efficacy and adverse effects before treatment and at the end of 2nd,4th,6th,and 8th week.Results: The therapeutic efficacy in Quetiapine group was similar to that in Risperidone group(P>0.05).MOAS weighted scores of Quetiapine group were lower than those of Risperidone group after 2 weeks of treatment,the difference of the two groups was statistically significance(P<0.05).Incidence of adverse effects in Quetiapine group was lower than that in Risperidone group,the difference was significant(P<0.05).Increased muscle tension and tremor of Quetiapine group were significant lower than those of Risperidone group in the adverse effects(P<0.05).Conclusions: The clinical effects of treatment of schizophrenia with aggressive behavior with Quetiapine and Risperidone is equal,but Quetiapine can quickly control aggressive behavior to improve treatment compliance.And the treatment with the Quetiapine has less adverse reactions and better safety.