利培酮治疗难治性精神分裂症随机对照研究

目的比较利培酮和氯氮平治疗难治性精神分裂症的疗效及安全性。方法共入组60例符合Kane难治性精神分裂症定义的患者,随机服用氯氮平和利培酮治疗,两组各30例,观察16周,分别于治疗前、治疗1周末、2周末、4周末、8周末、12周末、治疗16周末评定阳性症状和阴性症状量表(PANSS)、治疗中副反应量表(TESS)、功能总体评定量表(GAF)各一次。治疗前后还需评定韦氏记忆量表(MQ)和威斯康星卡片分类测验(WCST)各一次并测量体重。结果无论是服用氯氮平治疗的患者,还是服用利培酮治疗的患者,基线时各项指标没有差异,治疗第4周末GAF量表得分明显增加,治疗第8周末PANSS总分、阴性症状因子分明显降低,治疗第12周末PANSS总分及各因子分均明显降低,差异均有非常显著性。治疗第16周末,利培酮组TESS量表得分明显低于氯氮平组,而GAF量表得分明显高于氯氮平组,差异均有非常显著性。结论氯氮平和利培酮治疗难治性精神分裂症患者疗效相当,且利培酮的副反应更轻,更利于患者社会功能的改善。

A Randomized Controlled Study Of Treatment-Resistant Schizophrenia With Risperidone And Clozapine Treatment

objective To compare the efficacy and safety of risperidone and clozapine in treatment-resistant schizophrenic patients.Method 60 inpatients with treatment-resistant schizophrenia（Kane criteria） were randomly assigned to receive risperidone（n=30） or clozapine（n=30） for 16 weeks.The Positive and Negtive Syndrome Scale（PANSS）、Global Assessment of Function（GAF） and Treatment Emergent Symptoms Scale（TESS） were used to measure therapeutic efficacy and side effects at the baseline and 1,2,4,8,12,16 weeks after treatment.Weshcler Memory Scales（WMS） and Wisconsin Card Sorting Test were used to measure cognitive function before and after the end of treatment.Results Pretreatment PANSS、GAF and TESS scores did not differ between the groups.The PANSS total scores decreased and GAF increased significantly after 8、12、16 weeks treatment in both groups.GAF scores of clozapine group was lower significant than risperidone,and the increasing TESS scores of clozapine group was more significant than risperidone group after the end of treatment. Conclusions Risperidone and clozapine were both effective in treatment-resistant schizophrenic patients.Risperidone could be more tolerate and advantageous to cognition improvement.