奎硫平与奋乃静治疗脑血管病所致精神障碍对照研究

目的评价奎硫平与奋乃静治疗脑血管病所致精神障碍的临床疗效和安全性。方法将71例脑血管病所致精神障碍患者随机分为两组,研究组30例,对照组41例,均给予神经内科常规治疗,在此基础上研究组口服奎硫平治疗,对照组口服奋乃静治疗,观察6w.于治疗前及治疗1w、2w、4w、6w末采用简明精神病量表评定临床疗效,简明智能状况检查量表评定认知状况,副反应量表评定不良反应。结果治疗6w末,研究组显效率为70％,对照组为65．9％;两组治疗2w末起简明精神病量表评分均较治疗前有显著下降（P均〈0．01）,并随着治疗时间的延续呈持续性下降,其减分率呈持续性升高;同期两组间评分及减分率比较均无显著性差异（P〉0．05）。两组治疗前后简明智能状况检查量表评分虽无显著性差异（P〉0．05）,但对照组减分率高于研究组。两组出现的不良反应多为轻、中度,但对照组的发生率显著高于研究组;其中活动减少、嗜睡、震颤、视物模糊、便秘以及体重增加的发生率差异有显著性（P〈0．05）。结论奎硫平治疗脑血管病所致精神障碍疗效显著,与奋乃静相当,但对认知功能影响较小,不良反应较轻微,安全性高,依从性好。

A control study of quetiapine vs. perphenazine in mental disorders due to cerebrovascular disease

Objective To evaluate the efficacy and safety of quetiapine vs. perphenazine in the treatment of mental disorders due to cerebrovascular disease(MDCD). Methods 71 MDCD patients were randomly divided into two groups,both groups received routine treatment of neurology department,additionally research group(n=30) took orally quetiapine and control(n=41) did perphenazine for 6 weeks.The efficacy was assessed with the Brief Psychiatric Rating Scale( BPRS),cognition status with the Mini-Mental State Examination(MMSE) and adverse reactions with the Treatment Emergent Symptom Scale(TESS) before treatment and at the end of the 1st,2nd,4th and 6th week treatment.Results At the end of the 6th week, obvious effective rate was respectively 70% in the research and 65.9% in the control;since the end of the 2nd week, the BPRS scores of both groups lowered more significantly compared with pretreatment(P<0.01) and did continously with treatment,and their score-decrement rates elevated continously;there were no significant differences in synchroniaztion inetrgroup scores and score-decrement rates(P>0.05).Although there was no significant difference in pre-and post-treatment MMSE scores of both groups(P>0.05),score-decrement rate was higher in the control than in the research group. Adverse reactions of both groups were mild to moderate,but incidences of those were significantly higher in the control than in the research group;among them,the incidence of hypoactivity, drowsiness,tremor,blurred vision,constipation and weight gain had significant difference(P<0.05). Conclusion Quetiapine has an evedent effect equivalent to perphenazine in the treatment of mental disorders due to vascular disease,but less influence on cognitive function,mild adverse reactions,higher safety and better compliance.