齐拉西酮与利培酮治疗女性精神分裂症的对照研究

目的探讨齐拉西酮与利培酮治疗女性精神分裂症的临床疗效和安全性。方法将72例患者随机分为研究组(齐拉西酮)和对照组(利培酮)各36例,分别给予齐拉西酮及利培酮治疗8周,采用简明精神病量表(BPRS)≥40分、阳性与阴性症状量表(PANSS)≥60分的女性精神分裂症患者为研究对象,评定治疗前、治疗后2、4、8周减分上的差异。疗效按治疗8周时减分率评定,以痊愈+显效作为有效率评价。使用副反应量表(TESS)评定不良反应。结果研究组总有效率63.9%,对照组总有效率66.7%,两组疗效相当(P>0.05)。TESS评定中两组均有头晕、头痛、恶心、便秘等症状。但对照组则以静坐不能、肌张力增高,特别是体重增高及闭经率显著差异(P<0.05～0.01)。两组各时点BPRS、PANSS评分均较治疗前显著下降(P<0.05或0.01),但在8周研究组PANSS阴性症状分显著低于对照组,差异有统计学意义(P<0.05)。结论齐拉西酮治疗女性精神分裂症疗效与利培酮相当,但不良反应更轻,无明显体重增高、闭经等,是女性精神分裂症患者治疗的首选药物。

A controlled study of the effect of ziprasidone and risperidone in the treatment of female patient with schizophrenia

Objective To investigate the curative effect and safety of ziprasidone and risperidone in the treatment of female schizophrenia. Methods 72 patients were randomly divided into research group （ziprasidone） and control group （risperidone） 36 cases. They were respectively give ziprasidone or risperidone treatment for 8 weeks. The research ob- jects were selected by brief psychiatric rating scale （BPRS） of 40 or higher, the positive and negative symptoms scale （PANSS） of 60 or more, and they were evaluated before and after treatment on points 2, 4, 8 weeks. Curative effect rate was evaluated at the 8th week point of the treatment, with the criteria of heal and efficient. The adverse reactions were assessed by the side effect scale （TESS）. Results The total effective rate of the research group was 63.9%, total effec- tive rate of the control group was 66.7%, there was no difference between the 2 groups （P〉0. 05）. Dizziness, head- ache, nausea, constipation and other symptoms were appeared in TESS evaluation in both groups. But the control group was significantly different in akathisia and increased muscle tone, especially the weight increased and amenorrhea （P〈0. 05-0. 01）. BPRS and PANSS score at each point of both groups were significantly decreased after the treatment （P〈 0. 05 or 0. 01）, but in week 8, the PANSS negative symptom of the research group was significantly lower than the con- trol group, the difference was statistical （P〈0. 05）. Conclusion Ziprasidone treated female schizophrenia had a compara- ble curative effect with risperidone, but its adverse reaction was lighter with no significant weight increased and amenor- rhea, etc., it is the first medicament choice for female patients with schizophrenia.