氯氮平换用奎硫平治疗女性精神分裂症临床研究.DOCVIP

临床医学论文-氯氮平换用奎硫平治疗女性精神分裂症临床研究 【摘要】? 　　目的 探讨氯氮平换用奎硫平治疗女性精神分裂症的疗效与安全性。 方法 对85例应用氯氮平治疗的女性精神分裂症患者，采用交叉重叠换药法换用奎硫平治疗，观察8 w。于换药前及换药第2 w、4 w、6 w、8 w末采用阳性与阴性症状量表及副反应量表评定临床疗效与不良反应。 结果 换用奎硫平治疗第2 w末起阳性与阴性症状量表N因子分，治疗第4 w末起P、G、T因子分均较换药前呈明显下降趋势，治疗第8 w末与换药前比较有极显著性差异（P＜0.01）。患者换药前主观满意度为29.4%，换药8 w末为47%。换用奎硫平治疗后嗜睡、流涎、疲倦、窦性心动过速、体重增加、头晕等不良反应发生率均较换药前明显减少（P＜0.05）。 结论 氯氮平换用奎硫平治疗能进一步改善女性精神分裂症患者的阴性症状，满意度、安全性进一步提高。 【关键词】? 精神分裂症；女性；阴性症状；氯氮平；奎硫平；满意度 　　A control study of quetiapine replacing clozapine in female schizophrenics 　　【Abstract】 Objective? To explore the efficacy and safety of quetiapine replacing clozapine in female schizophrenics. Methods? 85 famale schizophrenics on clozapine were treated with quetiapine accoding to juxtaposition displacement for 8 weeks. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale(PANSS) and adverse effects with the Treatment Emergent Symptom Scale(TESS) before replacing and at the ends of the 2nd,4th,6th and 8th week after replacing.Results?After replacing, N factor score since the 2nd week treatment and P,G and T scores since the end of the 4th week lowered continiously compared with prereplacing, and at the end of the 8th week those were very significantly different from prereplacing(P0.01). Patients’ sujective satisfaction before replacing was 29.4% and 47% at the end of 8th week after replacing. Incidences of such adverse effects as drowsiness, salivation, weary,sinus tachycardia, weight gain and dizziness and so on lowered significantly compared with prereplacing(P0.05). Incidences of?drowsiness, salivation, languor, sinus tachycardia, weiught gain,dizziness and so on were reduced more significantly after than before replacement(P0.05). Conclusion?Quetiapine replacing clozapine in famale schizophrenics can further improve patients?negative sympmtoms and increase?satisfaction and safety. 　　【Keywords】 Schizophrenia; female; negative symptoms;clozapine; quetiapine; satisfaction? ??? 　　研究表明［1］，奎硫平对精神分裂症阳性、阴性、认知、情感症状均