奥氮平与利培酮治疗老年痴呆精神行为症状的疗效比较

目的：探讨奥氮平与利培酮治疗老年痴呆精神行为症状的疗效和安全性。方法：90例伴精神行为症状的老年痴呆患者随机分为两组各45例，分别给予奥氮平和利培酮口服治疗。采用PANSS评分评价疗效，用痴呆病理行为评定量表（BEHAVE—AD）评价患者的精神行为症状，用药物副反应量表（TESS）评定药物的不良反应。结果：奥氮平组的总有效率为93．3％，利培酮组为91．1％，两组总有效率比较差异无统计学意义（P〉0．05）；治疗后不同时间两组的PANSS总分和BEHAVE—AD量表评分与治疗前相比显著降低（P〈0．05），治疗后2周和4周奥氮平组的PANSS总评分优于利培酮组，治疗后2周奥氮平组的BEHAVE～AD量表评分由于利培酮组，奥氮平组的TESS评分显著低于利培酮组。结论：奥氮平与利培酮治疗老年痴呆精神行为症状均有良好的疗效，但奥氮平起效快，而且安全性好，值得在临床推广。

Comparison between the Clinical Effects of Olanzapine and Risperidone in Treatment of Alzheimer Patients with Behavioral and Psychological Symptoms

Objective： To explore the clinical effects and safety of olanzapine and risperidone in treatment of Alzheimer patients with behavioral and psychological symptoms. Method： 90 cases of the patients were randomly divided into two groups, 45 cases in each group, and gave olanzapine and risperidone oral treatment respectively. PANSS and BEHAVE-AD score were used to evaluate efficacy and behavioral and psychological symptoms of the patients, and TESS was used to assessment the adverse reaction. Result： The total effective rate of olanzapine group was 93.3%, and 91.1% in risperidone group, there was no signifi- cantly difference between the two groups（ P〉0.05 }. The PANSS total score and BEHAVE-AD score were significantly reduced after treatment （ P〈0.05 ）. The PANSS total score of olanzapine group were significantly better than risperidone group after treatment for 2 and 4 weeks. The BEHAVE-AD score of olanzapine group was significantly better than risperidone group after treatment for 2 weeks. The TESS score of olanzapine group was significantly less than risperidone group. Conclusion： Both olanzapine and risperidone are effective in Alzheimer patients with behavioral and psychological symptoms, but olanzapine effect is more rapidly and safety, is worth in clinical practice.