中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
4期
553-556
,共4页
精神分裂症%阿立哌唑%利培酮%临床疗效%副作用
精神分裂癥%阿立哌唑%利培酮%臨床療效%副作用
정신분렬증%아립고서%리배동%림상료효%부작용
Schizophrenia%Aripiprazole%Risperinone%Clinical efficacy%Side effect
目的 比较阿立哌唑和利培酮治疗精神分裂的有效性及安全性.方法 将102例患者采用随机数字表法分为2组:阿立哌唑组53例,应用阿立哌唑治疗,药物起始剂量为10 mg/d,在入组2周内根据病情变化情况逐渐将剂量增加至20 ～ 30 mg/d;利培酮组49例,应用利培酮治疗,药物初始剂量为1 nmg/d,在入组2周内根据病情变化情况逐渐将剂量增加至2 ～6 mg/d.于治疗前和治疗第4、8周评定并比较2组的阳性与阴性症状量表(PANNS量表)、副反应量表(TESS量表)评分和空腹血糖、血脂及体重指数值.结果 阿立哌唑组患者治疗前阳性症状、阴性症状、精神病理评分和PANSS总分分别为(25±7)、(21±5)、(38±10)、(85±15)分,治疗第4周分别为(15±6)、(15±5)、(29±7)、(59±13)分,治疗第8周分别为(11±5)、(11±5)、(21±6)、(44±11)分;利培酮组治疗前分别为(25±7)、(22±6)、(37±9)、(84±14)分,治疗第4周分别为(14±6)、(16±6)、(30 ±6)、(60±11)分,治疗第8周分别为(9±5)、(13 ±5)、(25 ±6)、(48 ±11)分;2组治疗后较治疗前均明显下降,差异有统计学意义(P＜0.05),且治疗第8周与第4周相比,各项指标也明显下降,差异有统计学意义(P＜0.05);但组间比较差异无统计学意义(P＞0.05).阿立哌唑组治疗第4、8周TESS评分分别为(10 ±5)、(8±4)分;利培酮组分别为(10±5)、(9±4)分;阿立哌唑组明显低于利培酮组,差异有统计学意义(P＜0.05).阿立哌唑组患者的空腹血糖、血脂和体重指数水平治疗后无明显改变(P＞0.05);而利培酮组患者治疗后空腹血糖、高密度脂蛋白胆固醇、三酰甘油及体重指数均较基线明显升高[(5.4±0.6)mmol/L比(4.8±0.6)mmol/L,(2.1±0.4)μmol/L比(1.3±0.4)μmol/L,(2.0±0.8)mmol/L比(1.2±0.3)mmoL/L,(24.1±1.2) kg/m2比(22.2 ±1.2)kg/m2],差异有统计学意义(P＜0.05).阿立哌唑组治疗后空腹血糖、高密度脂蛋白胆固醇、三酰甘油及体重指数[(4.8±0.6) mmol/L,(1.3±0.4)μmol/L,(1.4±0.4)mmol/L,(22.2±1.1) kg/m2]均明显低于利培酮组治疗后,差异均有统计学意义(均P ＜0.05).结论 立哌唑和利培酮在改善精神分裂症患者阳性、阴性及精神病理症状方面疗效相当,但阿立哌唑不良反应发生率低,对血糖血脂代谢影响更小,治疗安全性相对更高.
目的 比較阿立哌唑和利培酮治療精神分裂的有效性及安全性.方法 將102例患者採用隨機數字錶法分為2組:阿立哌唑組53例,應用阿立哌唑治療,藥物起始劑量為10 mg/d,在入組2週內根據病情變化情況逐漸將劑量增加至20 ～ 30 mg/d;利培酮組49例,應用利培酮治療,藥物初始劑量為1 nmg/d,在入組2週內根據病情變化情況逐漸將劑量增加至2 ～6 mg/d.于治療前和治療第4、8週評定併比較2組的暘性與陰性癥狀量錶(PANNS量錶)、副反應量錶(TESS量錶)評分和空腹血糖、血脂及體重指數值.結果 阿立哌唑組患者治療前暘性癥狀、陰性癥狀、精神病理評分和PANSS總分分彆為(25±7)、(21±5)、(38±10)、(85±15)分,治療第4週分彆為(15±6)、(15±5)、(29±7)、(59±13)分,治療第8週分彆為(11±5)、(11±5)、(21±6)、(44±11)分;利培酮組治療前分彆為(25±7)、(22±6)、(37±9)、(84±14)分,治療第4週分彆為(14±6)、(16±6)、(30 ±6)、(60±11)分,治療第8週分彆為(9±5)、(13 ±5)、(25 ±6)、(48 ±11)分;2組治療後較治療前均明顯下降,差異有統計學意義(P＜0.05),且治療第8週與第4週相比,各項指標也明顯下降,差異有統計學意義(P＜0.05);但組間比較差異無統計學意義(P＞0.05).阿立哌唑組治療第4、8週TESS評分分彆為(10 ±5)、(8±4)分;利培酮組分彆為(10±5)、(9±4)分;阿立哌唑組明顯低于利培酮組,差異有統計學意義(P＜0.05).阿立哌唑組患者的空腹血糖、血脂和體重指數水平治療後無明顯改變(P＞0.05);而利培酮組患者治療後空腹血糖、高密度脂蛋白膽固醇、三酰甘油及體重指數均較基線明顯升高[(5.4±0.6)mmol/L比(4.8±0.6)mmol/L,(2.1±0.4)μmol/L比(1.3±0.4)μmol/L,(2.0±0.8)mmol/L比(1.2±0.3)mmoL/L,(24.1±1.2) kg/m2比(22.2 ±1.2)kg/m2],差異有統計學意義(P＜0.05).阿立哌唑組治療後空腹血糖、高密度脂蛋白膽固醇、三酰甘油及體重指數[(4.8±0.6) mmol/L,(1.3±0.4)μmol/L,(1.4±0.4)mmol/L,(22.2±1.1) kg/m2]均明顯低于利培酮組治療後,差異均有統計學意義(均P ＜0.05).結論 立哌唑和利培酮在改善精神分裂癥患者暘性、陰性及精神病理癥狀方麵療效相噹,但阿立哌唑不良反應髮生率低,對血糖血脂代謝影響更小,治療安全性相對更高.
목적 비교아립고서화리배동치료정신분렬적유효성급안전성.방법 장102례환자채용수궤수자표법분위2조:아립고서조53례,응용아립고서치료,약물기시제량위10 mg/d,재입조2주내근거병정변화정황축점장제량증가지20 ～ 30 mg/d;리배동조49례,응용리배동치료,약물초시제량위1 nmg/d,재입조2주내근거병정변화정황축점장제량증가지2 ～6 mg/d.우치료전화치료제4、8주평정병비교2조적양성여음성증상량표(PANNS량표)、부반응량표(TESS량표)평분화공복혈당、혈지급체중지수치.결과 아립고서조환자치료전양성증상、음성증상、정신병리평분화PANSS총분분별위(25±7)、(21±5)、(38±10)、(85±15)분,치료제4주분별위(15±6)、(15±5)、(29±7)、(59±13)분,치료제8주분별위(11±5)、(11±5)、(21±6)、(44±11)분;리배동조치료전분별위(25±7)、(22±6)、(37±9)、(84±14)분,치료제4주분별위(14±6)、(16±6)、(30 ±6)、(60±11)분,치료제8주분별위(9±5)、(13 ±5)、(25 ±6)、(48 ±11)분;2조치료후교치료전균명현하강,차이유통계학의의(P＜0.05),차치료제8주여제4주상비,각항지표야명현하강,차이유통계학의의(P＜0.05);단조간비교차이무통계학의의(P＞0.05).아립고서조치료제4、8주TESS평분분별위(10 ±5)、(8±4)분;리배동조분별위(10±5)、(9±4)분;아립고서조명현저우리배동조,차이유통계학의의(P＜0.05).아립고서조환자적공복혈당、혈지화체중지수수평치료후무명현개변(P＞0.05);이리배동조환자치료후공복혈당、고밀도지단백담고순、삼선감유급체중지수균교기선명현승고[(5.4±0.6)mmol/L비(4.8±0.6)mmol/L,(2.1±0.4)μmol/L비(1.3±0.4)μmol/L,(2.0±0.8)mmol/L비(1.2±0.3)mmoL/L,(24.1±1.2) kg/m2비(22.2 ±1.2)kg/m2],차이유통계학의의(P＜0.05).아립고서조치료후공복혈당、고밀도지단백담고순、삼선감유급체중지수[(4.8±0.6) mmol/L,(1.3±0.4)μmol/L,(1.4±0.4)mmol/L,(22.2±1.1) kg/m2]균명현저우리배동조치료후,차이균유통계학의의(균P ＜0.05).결론 립고서화리배동재개선정신분렬증환자양성、음성급정신병리증상방면료효상당,단아립고서불량반응발생솔저,대혈당혈지대사영향경소,치료안전성상대경고.
Objective To compare the efficacy and safety of aripiprazole and risperinone in treatment of schizophrenic patients.Methods Totally 102 patients with schizophrenia were randomized into aripiprazole group (53 cases) and risperinone group (49 cases).And the level of PANSS,TESS,blood glucose,blood lipid and body mass index were recorded and compared in 4 and 8 weeks.Patients in aripiprazole group were all receipted aripiprazole,starting dose was 10 mg/d and increased gradually to the therapeutic dose of 20-30 mg/d according to the patients condition.Patients in the risperinone group were all receipted risperinone,starting dose was 1 mg/d and increased gradually to the therapeutic dose of 2-6 mg/d according to the patients condition.Results The positive symptom,negative symptom,general pathological factor and total score of the PANSS in the aripiprazole group before treatment were (25 ±7),(21 ±5),(38 ± 10),(85 ± 15),4 weeks after treatment the scores were (15 ± 6),(15 ±5),(29 ±7),(59 ± 13),8 weeks later were (11 ±5),(11 ±5),(21 ±6),(44 ± 11) ;The positive symptom,negative symptom,general pathological factor and total score of the PANSS in the risperinone group before treatment were (25 ± 7),(22 ± 6),(37 ± 9),(84 ± 14),4 weeks after treatment the scores were (14 ± 6),(16 ± 6),(30 ± 6),(60 ± 11),8 weeks later were (9 ± 5),(13 ± 5),(25 ± 6),(48 ± 11),the scores were all significantly decreased in both groups after treatment,and the degree of these factors decreased more significant in 4 weeks than in 8 weeks,all had statistic significance(P ＜ 0.05),but there was no statistic difference between two groups (P ＞ 0.05).The TESS score in the aripiprazole group were [4 weeks:(10 ± 5) ; 8 weeks:(7 ± 4)] ; in the risperinone group were [4 weeks:(10 ±5) ; 8 weeks:(9 ±4)],the difference in the 8 weeks was significantly difference (P ＜ 0.05).The blood glucose,blood lipid and body mass index in aripiprazole group had no significant changes after treatment compared to baseline(P ＞ 0.05),and the level of blood glucose,high density lipoprotein cholesterol,triglyceride and body mass index in risperinone group elevated more significantly after treatment than baseline [(5.4 ± 0.6) mmol/ vs (4.8 ± 0.6) mmol/L; (2.1 ± 0.4) μmol/L vs (1.3 ± 0.4) μmol/L;(2.0 ± 0.8) mmol/L vs (1.2 ± 0.3) mmol/L ; (24.1 ± 1.2) kg/m2 vs (22.2 ± 1.2) kg/m2] (P ＜ 0.05),and at the end of 8 weeks,the level of blood glucose,high density lipoprotein cholesterol,triglyceride and body mass index in aripiprazole group [(4.8 ± 0.6) mmol/L,(1.3 ± 0.4) μmol/L,(1.4 ± 0.4) mmol/L,(22.2 ± 1.1) kg/m2] were significantly lower than those in risperinone group (P ＜ 0.05).Conclusion Aripiprazole and risperinone have good effect in the treatment of schizophrenia,but aripiprazole has less adverse effects and more safety.
