奎硫平合用氯硝西泮治疗精神分裂症急性兴奋临床观察

目的:观察奎硫平合用氯硝西泮治疗精神分裂症急性兴奋的疗效及不良反应,以氯丙嗪和氯氮平为对照。方法:182例精神分裂症急性中度兴奋患者,随机分为奎硫平合用氯硝西泮(62例,简称合用组),氯丙嗪(60例,氯丙嗪组)和氯氮平(60例,氯氮平组)治疗,疗程1周。治疗前及治疗1周末评估阳性与阴性症状量表兴奋因子(PANSSEC)和治疗中需处理的不良反应。结果:合用组的疗效与氯丙嗪组、氯氮平组比较,均获得明显改善,差异均无显著性(P均>0.05)。氯丙嗪组锥体外系反应发生率高于合用组和氯氮平组(P<0.01)。氯氮平组嗜睡、便秘、流涎和心动过速的发生率高于合用组和氯丙嗪组(P<0.05)。结论:奎硫平合用氯硝西泮可有效治疗精神分裂症急性中度兴奋患者,与氯丙嗪和氯氮平的疗效相当,不良反应轻微。

Clinical study on efficacy of quetiapine combined with clonazepam treated with acute agitation in schizophrenia patients

Objective:To investigate the efficacy and adverse effects of quetiapine combined with clonazepam versus chlorpromazine or clozapine in the treatment of acute agitation in schizophrenia. Method:A total of 182 schizophrenics with acute moderate agitation were randomly received quetiapine combined with clonazepam(n=62) or chlorpromazine(n=60) or clozapine(n=60) treatment for a week.The patients were simultaneously assessed with the positive and negative syndrome scale excited components(PANSS-EC)and treatment emergent signs and symptoms(TESS)before and at the end of first week treatment. Results:The efficacy of quetiapine combined with clonazepam was comparable to chlorpromazine or clozapine (P>0.05).Incidence of extrapyramidal side-effects was significantly higher in chlorpromazine than quetiapine and clozapine(P<0.01).And clozapine was more easily to induce drowsiness, constipation, salivation and tachycardia than other groups(P<0.05). Conclusion:Quetiapine combined with clonazepam is efficacious for acute agitation in schizophrenia,and produces fewer side effects.