精神分裂症患者应用奥氮平氯氮平的不良反应及其对生活质量的影响

目的探讨国产奥氮平（欧兰宁）治疗精神分裂症的不良反应及对生活质量的影响。方法将64例精神分裂症患者按抽签法随机分成两组各32例。奥氮平组口服起始剂量为10mg／d，1周内根据病情及不良反应调整药物治疗剂量为10-20mg／d，治疗剂量（16．25±4．21）mg／d；氯氮平组口服起始剂量为50mg／d，治疗剂量（278．13±91．36）mg／d。两组治疗期间不联用其他抗精神病药、抗抑郁药、抗躁狂药，疗程为8周。由课题组成员在患者用药期间按不良反应症状量表的标准观察不良反应或询问患者，并记录各项不良反应的发生情况。于治疗前及治疗后8周末评价两组患者生活质量。结果奥氮平组发生嗜睡、便秘、流涎、头晕和晕厥等不良反应明显比氯氮平组少，差异有统计学意义（P〈0．05或P〈0．01）；治疗前两组患者生活质量4个维度得分比较差异均无统计学意义（P〉0．05），但经8周治疗后，两组患者除物质生活维度外，躯体健康、心理健康、社会功能维度比较差异均有统计学意义（P〈0．01）。结论精神分裂症患者服用奥氮平治疗，不良反应较轻，生活质量较高。

Observation of Adverse Reactions and Influence on Patients'''' Life Quality of Olanzapine and Clozapine in Treating Schizophrenics

Objective To explore the adverse reactions and influence on patients＇ life quality of Olanzapine in treating schizophrenics. Methods 64 patients with schizophrenics were randomly divided into two groups, each with 32 cases. The initial oral dosage for the Olanzapine group was 10 mg/d, and within 1 week was adjusted to 10-20 mg/d according to the state of illness and adverse reactions, with treatment dosage being （16.25±4.21）mg/d. The initial oral dosage for the Clozapine group was 50 mg/d, with treatment dosage being （278.13±91.36）mg/d. For both groups, neither anti-psychotic drugs, anti-depressants nor anti-hysteria drugs were used in the 8 weeks of treatment. Patients＇ adverse reactions observed or ranked through inquiries against the standard of adverse reactions scale by members on the research team, and the number of eases with the various adverse reactions were recorded. Patients＇ life quality was evaluated before the treatment and at the end of the 8 weeks of treatment. Results The incidence of adverse reactions such as sleepiness, constipation, salivation, dizziness and syncope among the Olanzapine group were lower than those of the Clozapine group, the differences being statistically significant （P〈0.05, P〈0.01）. The difference in the four-dimension score of the life quality of the two groups before the treatment had no statistical significance （P〉0.05）. After 8 week＇s treatment, however, the differences on the dimensions of physical health, mental health and social function took on statistical significance （P〈0.01）, the dimension of material life not included. Conclusion The adverse reactions of Olanzapine in treating schizophrennics are more slight and patients can have a better life quality.