奥氮平与氯氮平治疗精神分裂症对照研究.DOCVIP

临床医学论文-奥氮平与氯氮平治疗精神分裂症对照研究 【关键词】? 精神分裂症；奥氮平；氯氮平 　　【摘要】 目的?? 探讨奥氮平治疗精神分裂症的疗效和安全性。 方法?? 将60例精神分裂症患者随机分为研究组和对照组，每组各30例。研究组应用奥氮平治疗，起始剂量5mg?d-1,第2d增至10mg?d-1，最大剂量≤20mg?d-1；对照组应用氯氮平治疗，起始剂量50mg?d-1，1w内递增到300mg?d-1，最大剂量≤400mg?d-1。疗程均为8w。分别于治疗前及治疗第1、2、4、6、8w末采用阳性和阴性症状量表评定临床疗效，副反应量表评定不良反应。 结果?? 奥氮平有效率73.33%，氯氮平有效率76.66%；奥氮平在改善认知因子和阴性症状方面优于氯氮平，两组比较差异有显著性（P＜0.05)；奥氮平组主要不良反应有轻度头昏、瞌睡、体重增加等。 结论?? 奥氮平是一种安全有效的抗精神病药物，对改善认知功能和阴性症状效果显著。 　　【关键词】 精神分裂症；奥氮平；氯氮平 　　A controlled study of olanzepine versus clozapine in schizophrenia 　　【Abstract】 Objectives?? To explore the curative effects and safety of olanzepine in the treatment of schizophrenia. Methods?? 60 schizophrenics were randomly divided into research (olanzepine, n=30) and controlled ( clozapine, n=30 ) groups . Initial dosage of olanzepine was 5mg/d , raised to 10mg/d on the 2nd day and the maximal was ≤20mg/d; initial dosage of clozapine was 50mg/d, raised to 300mg/d within one week and the maximal was≤400mg/d? for 8 weeks. Curative effects were assessed with the Positive and Negative Symptom Scale (PANSS) and side effects with the Treatment Emergent Symptom Scale(TESS) before treatment and at the ends of week 1,2,4,6 and 8, respectively.?Results牋 The rates of olanzepine and clozapine were 73.33% and 76.66% respectively; olanzepine was better than clozapine in improving cognitive factor and negative symptoms, the difference was significant(P0.05); The main side effects of olanzepine were mild dizziness, drowsiness, weight gain etc. Conclusion牋 Olanzepine is an effective and safe neuroleptic, especially? effectively improves cognitive function and negative symptoms. 　　【Keywords】 Schizophrenia；olanzepine；clozapine 　　奥氮平（商品名再普乐）是一种新型非典型抗精神病药，其化学结构属噻吩苯二氮艹[]卓类衍生物，药理作用与氯氮平相似。奥氮平对多受体均有较强的亲和力，能有效治疗精神分裂症、分裂样精神病和分裂情感性精神障碍的阳性和阴性症状，改善认知障碍，且较少或不引起传统抗精神病药物所致的锥体外系不良反应。现对奥氮平与氯氮平进行随机对照研究，以评价奥氮平治疗精神分裂症的疗效及安全性，现将结果报告如下。 　　1 对象与方法 　　1.1 对象?? 病例选自2004年1月～7月我院住院的60例精神分裂症患者。入组标准：（1）符合《中国精神障碍分类与诊断标准》第3版（CCMD3）精神分裂症诊断标准；（2）年龄18～60a，性别不限；（3）入院前1w内未服用抗精