奎的平与氯氮平治疗精神分裂症的对照研究

目的 比较奎的平、氯氮平对精神分裂症患者认知功能的影响及其疗效、副作用。方法 采用随机分配原则，选择符合CCMD-3精神分裂症诊断标准的患者50例，分奎的平组和氯氮平组治疗8周，治疗前、治疗8周末用阴性与阳性症状量表(PANSS)、韦氏成人智力测验中不分心／记忆因子(FD／M)、韦氏记忆测验（WMS)、威斯康星卡片分类测验(WCST)、以及药物副作用评定量表(TESS)评估。结果 患者经过8周治疗，PANSS总分均下降，两组之间疗效差异无显著性，PANSS各因子评分亦无差异。两组对精神分裂症患者认知功能的改善均有效，在记忆评定中奎的平组对累加、记忆总分的改善与氯氮平组比较差异有显著性。氯氮平较奎的平的副作用多，各种副作用中氯氮平组在嗜睡、活动减少、视物模糊、便秘、唾液增多、头昏晕厥、血糖增高、体重增加的评分较奎的平组高，两组比较差异有显著性。结论 奎的平与氯氮平在治疗精神分裂症中疗效相当；奎的平对认知功能有较好的改善；且副作用较氯氮平更少；是治疗精神分裂症患者理想的一线药。

A comparative study of quetiapine and clozapine in the treatment of schizophrenia

Objective To compare the effect of quetiapine and clozapine on cognitive function and their efficacy and side effects. Methods Gifty patients who met CCMD-3 criteria for schizophrenia were randomly assigned to receiving quetiapine or clozapine for 8 weeks. PANSS, FD/M,WMS, WCST and TESS were used to evaluate efficacy,cognitive function and side effects.Results The total scores of PANSS in two groups were significantly decreased after treatment and there was no significant difference between two groups.Both groups showed improvement in cognitive function,while there were significant differences on total score and factor score of accumulation in memory scale between two groups.More patients in the clozapine group reported dorowsiness,reduction of activity,constipation,increasing of saliva,dizzyness,high blood glucose,weight increasing.Conclusion Quetiapine has similar efficacy and fewer side effects with clozapine,and can improve cognitive funition,which is an ideal first-line durg for schizophrenia.