齐拉西酮与利培酮治疗首发精神分裂症的对照研究

目的探讨齐拉西酮治疗首发精神分裂症患者的疗效与安全性。方法 64例符合CCMD-3诊断的精神分裂症患者随机分为齐拉西酮组(32例)和利培酮组(32例),观察8周。采用阳性与阴性症状量表(PANSS)评定疗效,副反应量表(TESS)评定不良反应,在治疗前及治疗第2、4、8周末各评定1次。结果齐拉西酮组有效率为84.38%,利培酮组为87.50%。两组比较差异无显著性(χ2=0.13,P>0.05)。治疗前两组PANSS总分及各因子分无显著性差异(P>0.05)。两组治疗前后比较,齐拉西酮组PANSS总分及各因子分治疗第2周末起下降有非常显著性差异(t=2.83～17.71,P<0.01);利培酮组PANSS总分及各因子分治疗2周末起下降有非常显著性差异(t=2.95～17.34,P<0.01)。两组治疗同期比较差异无显著性(P>0.05)。齐拉西酮组锥体外系反应、体重增加、女性月经改变方面不良反应少于利培酮组,两组差异有显著性(χ2=4.60～7.05,P<0.05),两组在头痛、头昏、失眠、嗜睡、心动过速、肝功能异常方面差异无显著性(χ2=0.14～2.74,P>0.05)。结论齐拉西酮是一种安全、有效的抗精神病药,较适合女性精神分裂症患者。

The Comparative Study of Ziprasidone and Risperidone in the Treatment of Schizophrenia

Objective To compare the efficacy and safety of ziprasidone and risperidone in treatment of schizophrenia.Methods A total of 64 cases met the CCMD-3 diagnosis of schizophrenia were randomly assigned to ziprasidone group（32 cases）and risperidone group（32 cases）.They received 8-week treatment;The efficacy was assessed by positive symptoms and negative symptoms scale（PANSS）,adverse side effects were evaluated with treatment Emergent Symptom Scale（TESS）before and after 2,4,8 week treatment.Results Ziprasidone effective rate was 84.38%,87.50% for the risperidone group.Difference between two groups had no significant（χ2=0.13,P0.05）.In two groups before treatment PANSS total and factor scores showed no significant difference（P0.05）.From 2 week treatment,Ziprasidone group＇ PANSS total and factor scores had very significant differences between before and after treatment（t=2.83～17.71,P0.01）;The risperidone group＇ PANSS total and factor scores had also very significant difference（t=2.95～17.34,P0.01）.there were no significant differences between two groups（P0.05）.The frequency of extrapyramidal reactions,weight gain,menstrual changes in women were significantly less in ziprasidone group than in risperidone group（χ2=4.60～7.05,P0.05）.In two groups,there were no significant differences in dizziness,insomnia,headache,drowsiness,heartbeat rate,abnormal liver function（χ2=0.14～2.74,P0.05）.Conclusions Ziprasidone is a safe and effective antipsychotics,especially for female patients with schizophrenia.