奥氮平治疗精神分裂症临床观察

目的了解奥氮平治疗精神分裂症的疗效和安全性。方法同时符合CCMD-3精神分裂症诊断标准和连续30天以上使用其他药物并且疗效不佳或有严重副反应不能耐受。需要换药治疗两项基本条件45例，停用已用抗精神病药物，改用奥氮平5～20mg／d，共治疗8周，以阳性和阴性症状量表（PANSS）评定临床疗效，以TESS和实验室监测评价安全性。结果45例患者中，基本痊愈13例（28．89％），显著进步17例（37．78％），好转9例（36．00％），无效6例（13．33％），总有效率达86．67％。不良反应：轻微震颤1例，白天思睡6例，口干3例，鼻塞1例，轻微恶心1例，均未处理。4周后体质量增加16例（35．56％），体质量增加2～6kg不等。结论奥氮平对阳性、阴性症状以及一般精神病症状均有良好疗效，常见副反应为嗜睡、体质量增加等。奥氮平替代其他药物后，总体安全有效，患者的服药依从性好。

Clinical Observations of Olanzapine Replacement in Treatment 45 Paotients with Schizophrenia

OBJECTIVE To explore the effect and safety of Olanzapine treatment of schizophrenia. METHODS The 45 schizophrenic patients should accord with the diagnosis of CCMD-3 and with the other medication excluded Olanzapine for 30 days. Furthermore, the patients should have no severe side effects and not good effect needing replacement. So the patients＇ medication was replaced by Olanzapine 5-20 mg/day for 8 weeks. And then the patients were assessed with PANSS , TESS and labor tests. RESULTS Among the 45 patients, almost recovery included 13 cases （28.89%）, notably improvement was 17 cases （37.78%）, improvement was 9 cases （36.00%）, inefficacy was 6 cases （13.33%）, and the total efficacy rate was 86.67%. The side effect included 1 case of tiny tremor, 6 cases f day sleeping, 3 cases of dry mouth, and lcase of snuffle and 1 case of tiny nausea, which were not dealt with. After 4 weeks, 16 case appeared weight gaining （35.56%）, varying from 2 to6 kilograms. CONCLUSIONS Olanzapine is good for positive, negative and general psychotic syndromes. The common side effects are cholinergic effects, lethargy and weight gaining and so on. Olanzapine is good for replacement to others, and has good safety and compliance.