氨磺必利与利培酮治疗脑血管病所致精神障碍疗效观察

目的探讨氨磺必利治疗脑血管病所致精神障碍患者的疗效和安全性。方法将60例脑血管病所致精神障碍患者随机分为两组，每组30例，分别给予氨磺必利与利培酮治疗8周，采用阳性与阴性症状量表（PANSS）、日常生活能力量表（ADL）评定疗效，治疗中出现的症状量表（TESS）评定不良反。结果治疗8周后，氨磺必利组有效率93．3％，利培酮组有效率90．0％，两组疗效比较差异无统计学意义（P〉0．05）；治疗2周末起，PANSS总分和各因子分较治疗前均有显著下降（P〈0．05或0．01），且随着治疗的持续进行各分值继续下降；两组间同期比较无显著性差异（P均〉0．05）；两组不良反应均较少、较轻，氨磺必利组主要表现为失眠、恶心、头晕、静坐不能等；利培酮组主要表现为恶心，嗜睡、EPS（肌强直、静坐不能、震颤）、直立性低血压、心电图异常等。结论氨磺必利与利培酮治疗脑血管病所致精神障碍患者的疗效相当，安全性高、耐受性好，值得在临床中推广应用。

Clinical observation of Tolbutamide with risperdal on treatment of mental disorder caused by cerebrovascular disease

Objective To explore the tolbutamide will the treatment of cerebrovascular disease caused by the efficacy and safety of people with mental disorders. Methods Totally 60 patients with mental disorder caused by cerebrovascular disease were randomly divided into two groups, 30 cases in each group, respectively give tolbutamide will benefit and risperidone treatment for 8 weeks, the positive and negative symptoms scale （PANSS） , daily life ability scale （ADL）evaluation of curative effect, in the treatment of the symptoms scale （TESS）. Results After 8 weeks treatment, the tolbutamide will group effective rate was 93.3%, and 90.0% efficient risperidone group, two groups of curative effect of comparative differences had no statistical significance （P 〉 0. 05 ） ;Treatment 2 weekend, the PANSS score and each factor score be- fore treatment were significantly decreased （ P 〈 0. 05 or 0. 01 ）, and as the treatment for each score continues to fall ; During lhe same period there was no significant difference between the two groups （P 〉 0.05 ） ;Two groups of adverse reactions are less and less, tolbutamide will benefit group mainly for insomnia, nausea, dizziness, akathisia, etc ; Risperidone group mainly for nausea, drowsiness, EPS （ myotonia, akathisia, tremor） , orthostatic hypotension, abnormal electrocardiogram （ecg）, etc. Conclusion Tolbutamide will benefit with risperidone treatment the curative effect of patients with mental disorder caused by cerebrovascular disease, high safety and good tolerance,is worth popularizing in clinical application.