不同剂量阿立哌唑治疗精神分裂症的疗效与安全性比较

目的探讨不同剂量阿立哌唑治疗精神分裂症的疗效与安全性。方法将128例符合CCMD-3标准的精神分裂症患者随机分为阿立哌唑10mg／d（A组）、15mg／d（B组）、20mg／d（C组）和25mg／d（D组）四个治疗组。使用PANSS量表和CGI—SI评定疗效，以TESS量表评定不良反应。观察4周。结果20mg／d和25mg／d治疗组的CGI—SI、PANSS量表总分、阳性症状分以及25mg／d治疗组的一般精神病理分在第1周末即有显著性改善（P〈0．05，P〈0．01），而10mg／d和15mg／d治疗组的CGI—SI、PANSS量表总分、阳性症状分、阴性症状分及一般精神病理分在第2周末有显著性改善（P〈0．05，P〈0.01）。在第4周末，15mg／d、20mg／d和25mg／d三个组间疗效比较无显著性差异（P〉0.05），且均优于10mg／d治疗组（P〈0．05），四个组的有效率分别为67．74％，82．35％，81．81％和83．33％。20mg／d和25mg／d组的不良反应大于10mg/d和15mg／d组（P〈0．05）。阿立哌唑常见的不良反应为失眠、困倦乏力、焦虑、静坐不能、肌强直、头晕、便秘、头痛、震颤、食欲下降、心动过速。结论阿立哌唑对精神分裂症的阳性、阴性症状都有效，15mg／d是较佳的治疗剂量，其不良反应较少，增大剂量可加快起效，但不良反应亦随之增加。

A comparative study on efficacy and safety of various doses of aripiprazole in the treatment of patients with schizophrenia

Objective To assess the adequate dosage range and the side-effects of aripiprazole in the treatment of patients with schizophrenia.Methods 128 patients with schizophrenia who met with the CCMD-3 were randomly allocated to receive 10mg,15mg,20mg or 25mg aripiprazole for 4 weeks.Efficacy and safety were assessed by PANSS,CGI-SI and TESS respectively.Results The total score of PANSS,positive factor,CGI-SI in 20mg and 25mg groups significant changed after 1 week treatment compared with baseline(P<0.05,P<0.01).At the end of week 2 after treatment,significant differences in scores of total PANSS,positive factor,negative factor,general factor and CGI-SI in 10mg and 15mg groups compared with baseline(P<0.05,P<0.01).The total scores of PANSS,positive factor,negative factor,general factor and CGI-SI in 15mg,20mg and 25mg groups were no significant differences each other(P>0.05),but better than that in 10mg group(P<0.05).The effective rate was 67.74%,82.35%,81.81% and 83.33% for 10mg,15mg,20mg and 25mg groups respectively.The scores of TESS in 20mg,25mg groups were significantly higher than 10mg,15mg groups(P<0.05).The most common side-effects of aripiprazole were insomnia,hypodynamia,anxiety,akathisia,myotonia,dizziness,constipation,headache,tremor,anepithymia and tachycardia.Conclusion Aripiprazole is effective in treatment of both negative and positive symptoms of schizophrenia,a best dosage of 15mg per day can provide better clinical effects and less side-effects.