中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
9期
1157-1159
,共3页
儿童精神分裂症%奥氮平%氯氮平%阳性与阴性症状量表
兒童精神分裂癥%奧氮平%氯氮平%暘性與陰性癥狀量錶
인동정신분렬증%오담평%록담평%양성여음성증상량표
Childhood schizophrenia%Olanzapine%Clozapine%Positive and negative syndrome scale
目的 以氯氮平为对照,探讨奥氮平治疗儿童精神分裂症的疗效与安全性.方法 将120例精神分裂症患者按入院顺序随机分成研究组和对照组,各60例.研究组患者服用奥氮平,起始剂量2.5 mg/d,第3天添加剂量至5 mg/d,此后视病情变化调节剂量,最大不超过15 mg/d；对照组患者服用氯氮平,起始剂量12.5 mg/d,1周内加到150 mg/d,此后视病情变化调节剂量,最大不超过300 mg/d.2组患者于治疗前和治疗8周末采用阳性和阴性症状量表(PANSS)和治疗意外症状量表(TESS)评定疗效和不良反应.结果 研究组总有效率为73.3％ (44/60),对照组总有效率为76.7％ (46/60)；2组患者总有效率比较,差异无统计学意义(P＞0.05).研究组和对照组治疗8周末,PANSS总分较治疗前均降低[研究组:(41.8±13.1)分比(81.2±13.7)分；对照组:(43.2±13.5)分比(79.2±10.5)分],阳性因子、阴性因子、认知功能、兴奋/激惹和焦虑/抑郁评分均较治疗前明显降低(均P ＜0.05).治疗8周末,研究组阴性因子、认知功能及焦虑/抑郁评分均明显低于对照组[分别为( 17.4±7.3)分比(24.7±8.2)分、(3.3±3.4)分比(8.2±4.2)分、(5.1±2.4)分比(8.7±3.1)分],差异均有统计学意义(P ＜0.05或P＜0.01).研究组主要不良反应为轻度头晕[ 16.7％ (10/60)]、口干[16.7％ (10/60)]、体重增加[15.0％ (9/60)]等,对照组主要不良反应为唾液增多[40.0％ (24/60)]、体重增加[40.0％ (24/60)]、轻度头晕[26.7％ (16/60)]等,研究组心动过速、嗜睡、血象异常、唾液增多、恶心呕吐、轻度头晕、体重增加、鼻塞、视力模糊、便秘、低血压、食欲增强发生率明显低于对照组(P＜0.05).结论 奥氮平是一种安全、有效的非典型抗精神病药物,可作为治疗儿童精神分裂症的一线用药.但因本研究仅限于12岁以上儿童,且研究时间短、样本量偏少,无法确切反映长时间治疗的疗效,有待于进一步大样本、长时间的研究.
目的 以氯氮平為對照,探討奧氮平治療兒童精神分裂癥的療效與安全性.方法 將120例精神分裂癥患者按入院順序隨機分成研究組和對照組,各60例.研究組患者服用奧氮平,起始劑量2.5 mg/d,第3天添加劑量至5 mg/d,此後視病情變化調節劑量,最大不超過15 mg/d；對照組患者服用氯氮平,起始劑量12.5 mg/d,1週內加到150 mg/d,此後視病情變化調節劑量,最大不超過300 mg/d.2組患者于治療前和治療8週末採用暘性和陰性癥狀量錶(PANSS)和治療意外癥狀量錶(TESS)評定療效和不良反應.結果 研究組總有效率為73.3％ (44/60),對照組總有效率為76.7％ (46/60)；2組患者總有效率比較,差異無統計學意義(P＞0.05).研究組和對照組治療8週末,PANSS總分較治療前均降低[研究組:(41.8±13.1)分比(81.2±13.7)分；對照組:(43.2±13.5)分比(79.2±10.5)分],暘性因子、陰性因子、認知功能、興奮/激惹和焦慮/抑鬱評分均較治療前明顯降低(均P ＜0.05).治療8週末,研究組陰性因子、認知功能及焦慮/抑鬱評分均明顯低于對照組[分彆為( 17.4±7.3)分比(24.7±8.2)分、(3.3±3.4)分比(8.2±4.2)分、(5.1±2.4)分比(8.7±3.1)分],差異均有統計學意義(P ＜0.05或P＜0.01).研究組主要不良反應為輕度頭暈[ 16.7％ (10/60)]、口榦[16.7％ (10/60)]、體重增加[15.0％ (9/60)]等,對照組主要不良反應為唾液增多[40.0％ (24/60)]、體重增加[40.0％ (24/60)]、輕度頭暈[26.7％ (16/60)]等,研究組心動過速、嗜睡、血象異常、唾液增多、噁心嘔吐、輕度頭暈、體重增加、鼻塞、視力模糊、便祕、低血壓、食欲增彊髮生率明顯低于對照組(P＜0.05).結論 奧氮平是一種安全、有效的非典型抗精神病藥物,可作為治療兒童精神分裂癥的一線用藥.但因本研究僅限于12歲以上兒童,且研究時間短、樣本量偏少,無法確切反映長時間治療的療效,有待于進一步大樣本、長時間的研究.
목적 이록담평위대조,탐토오담평치료인동정신분렬증적료효여안전성.방법 장120례정신분렬증환자안입원순서수궤분성연구조화대조조,각60례.연구조환자복용오담평,기시제량2.5 mg/d,제3천첨가제량지5 mg/d,차후시병정변화조절제량,최대불초과15 mg/d；대조조환자복용록담평,기시제량12.5 mg/d,1주내가도150 mg/d,차후시병정변화조절제량,최대불초과300 mg/d.2조환자우치료전화치료8주말채용양성화음성증상량표(PANSS)화치료의외증상량표(TESS)평정료효화불량반응.결과 연구조총유효솔위73.3％ (44/60),대조조총유효솔위76.7％ (46/60)；2조환자총유효솔비교,차이무통계학의의(P＞0.05).연구조화대조조치료8주말,PANSS총분교치료전균강저[연구조:(41.8±13.1)분비(81.2±13.7)분；대조조:(43.2±13.5)분비(79.2±10.5)분],양성인자、음성인자、인지공능、흥강/격야화초필/억욱평분균교치료전명현강저(균P ＜0.05).치료8주말,연구조음성인자、인지공능급초필/억욱평분균명현저우대조조[분별위( 17.4±7.3)분비(24.7±8.2)분、(3.3±3.4)분비(8.2±4.2)분、(5.1±2.4)분비(8.7±3.1)분],차이균유통계학의의(P ＜0.05혹P＜0.01).연구조주요불량반응위경도두훈[ 16.7％ (10/60)]、구간[16.7％ (10/60)]、체중증가[15.0％ (9/60)]등,대조조주요불량반응위타액증다[40.0％ (24/60)]、체중증가[40.0％ (24/60)]、경도두훈[26.7％ (16/60)]등,연구조심동과속、기수、혈상이상、타액증다、악심구토、경도두훈、체중증가、비새、시력모호、편비、저혈압、식욕증강발생솔명현저우대조조(P＜0.05).결론 오담평시일충안전、유효적비전형항정신병약물,가작위치료인동정신분렬증적일선용약.단인본연구부한우12세이상인동,차연구시간단、양본량편소,무법학절반영장시간치료적료효,유대우진일보대양본、장시간적연구.
Objective To determine the efficacy and safety of olanzapine in the treatment of childhood schizophrenia by using clozapine as a control.Methods All 60 cases with childhood schizophrenia were randomly divided into research group and control group (n =60 each group).The patients in research group took olanzaping with a starting dose 2.5 mg/d,and the patients in control group took clozaping with a starting dose 12.5 mg/d.The positive and negative syndrome scale(PANSS)and treatment emergent symptom scale(TESS)were used to evaluate the effect and adverse reaction before and after treatment for 8 weeks.Results There was no significant difference in curative effect between research group and control group [ 73.3％ (44/60)vs 76.7％ (46/60),P ＞ 0.05 ].The scores of PANSS in research group and control group after treatment for 8 weeks were lower than those before treatment [ research group:(41.8±13.1 )scores vs(81.2±13.7 )scores;control group:(43.2±13.5 )scores vs (79.2±10.5 )scores,all P＜0.05 ],and the scores of positive factors,negative factors,cognitive function,excitement/irritation and anxiety/depression in two groups after treatment for 8 weeks were lower than those before treatment.After treatment for 8 weeks,compared with control group,the scores of negative factors,cognitive function and anxiety/depression in research group decreased [ (17.4±7.3)scores vs(24.7±8.2)scores,(3.3±3.4)scores vs(8.2±4.2 )scores,(5.1±2.4 )scores vs (8.7±3.1 )scores,respectively,P＜0.05 or P＜0.01 ].The adverse reactions were mild dizzy [ 16.7％ (10/60 )],thirst [ 16.7％ (10/60 )] and weight gain [ 15.0％(9/60)] in research group and increased saliva [ 40.0％ (24/60 )],weight gain [ 40.0％ (24/60 )],mild dizzy [26.7％ (16/60)] in control group.The rates of adverse reaction about tachycardia,drowsiness,abnormal blood picture,increased saliva,nausea and vomitting,mild dizzy,weight gain,nasal congestion,blurred vision,constipation,hypotension,appetite enhancement in research group were lower than those in control group (all P ＜0.05).Conclusion Olanzapine is a safe,effective agent in the treatment of childhood schizophrenia,and can be used as first-line drug for treatment of childhood schizophrenia.
