国产奥氮平与氯氮平治疗精神分裂症对照研究

目的 评价国产奥氮平与氯氮平治疗精神分裂症的临床疗效及安全性.方法 将72例精神分裂症患者随机分为两组,每组36例,分别口服奥氮平和氯氮平治疗,观察8周.于治疗前及治疗2周、4周、6周、8周末采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应.结果 治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降(P＜0.01),治疗4周末奥氮平组阴性症状因子分较氯氮平组下降更显著(P＜0.01);治疗8周末,氯氮平组显效率68.58%、有效率91.42%,奥氮平组分别为69.44%、88.89%,两组疗效差异无显著性(P＞0.05).两组不良反应多为轻度到中度,经对症处理后均可缓解或消失,氯氮平组流涎、嗜睡、心动过速、便秘发生率均显著高于奥氮平组(P＜0.05或0.01).结论 奥氮平治疗精神分裂症疗效与氯氮平相当,但奥氮平改善阴性症状更快,安全性更高,依从性更好.

A control study of domestic olanzapine vs.clozapine in schizophrenia

Objective to evaluate the clinical efficacy and safety of domestic olanzapine vs. clozapine in the treatment of schizophrenia. Methods Seventy-two schizophrenics were randomly assigned to two groups of 36 patients each took orally olanzapine or clozapine for 8 weeks. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS） before treatment and at the end of the 2^nd , 4^th , 6^th and 8^th week and adverse reactins with the Treatment Emergent Symptom Scale （TESS）. Results After treatment total and each factor scores of the PANSS of both groups lowered more significantly compared with pretreatment （P〈0.01）, so did the scores of negative symptoms in olanzapine than in clozapine group at the end of the 4th week （P〈0.01） ; at the end of the 8^th week, obvious effective and effective rates were 68.58% and 91.42% in the olanzapine and 69.44% and 88. 89% in clozapine group respectively, which showed no significant differences （P〉0.05）. Adverse reactions of both groups were mild to moderate and could relieve or disappear after symptomatic treatment, incidences of salivation, hypersomnia, tachycardia and constipation were significantly higher in the clozapine than in the olanzapine group （P〈0.05 or 0.01）. Conclusion Olanzapine has a curative effect equivalent to clozpaine in the treatment of schizophrenia, but the former improves negative symptoms more rapidly and has higher safety and better compliance.