氯氮平与利培酮治疗精神分裂症对照研究

目的 探讨氯氮平与利培酮治疗精神分裂症的临床疗效和安全性.方法 将48例精神分裂症患者随机分为两组,每组24例.氯氮平组口服氯氮平治疗,利培酮组口服利培酮治疗,观察8周.于治疗前及治疗第2周、4周、8周末采用阳性与阴性症状量表评定疗效,副反应量表评定不良反应.结果 治疗2周末起,两组阳性与阴性症状量表总分及阳性症状、精神病理因子分较治疗前显著下降(P＜0.05或0.01),治疗4周末起,两组阴性症状因子分较治疗前显著下降(P＜0.01);同期两组间比较差异均无显著性(P＞0.05);治疗8周末,氯氮平组显效率87.50%,利培酮组为83.33%,两组差异无显著性(P＞0.05).氯氮平组嗜睡、体质量增加、心动过速发生率均显著高于利培酮组(P＜0.05或0.01),而震颤、颈项强直、静坐不能、闭经、催乳素升高发生率均显著低于利培酮组(P＜0.01).结论 氯氮平与利培酮治疗精神分裂症患者疗效相当,氯氮平锥体外系反应较少,对催乳素影响更小,价格较低,但在应用过程中应注意监测血象.

A control study of clozapine vs risperidone in the treatment of schizophrenia

Objective To explore the efficacy and safety of clozapine and risperidone in the treatment of schizophrenia. Methods Forty-eight schizophrenics were randomly assigned to two groups of 24 ones each, clozapine group took orally clozapine and risperidone group did risperidone for 8 weeks. Effieacies were assessed with the Positive and Negative Syndrome Scale （PNSS） and adverse reactions with Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 2^nd, 4^th and 8^th week. Resuits At the end of the 2^nd week, the total, positive symptom, psychiatric pathology scores of both groups lowered more significantly （P〈0.05 or 0.01）, so did the negative symptoms＂ scores of both groups since the end of the 4^th week （P〈0. 01）; there were no significant differences in contemporaneous group comparisons （P〉0.05） ; at the end of the 8^th week, obvious effective rates were respectively 87.5% in cloza pine and 83.3% in risperidone group,which showed no significant differences （P〈0.05）. The incidences of hypersomnia, weight gain and tachycardia were significantly higher （P〈0. 05 or 0.01） and those of tremor, neck rigidity, akathisia, amenorrhea, prolactin elevation lower （P〈0.01） in clozapine than in risperidone group. Conclusion Both clozapine and risperidone are effective on schizophrenia, clozpine＇s extra pyramidal symptoms fewer, has less influence on prolactin and lower price, but haemogram should be detected during its utilization.