4种第二代抗精神病药物治疗精神分裂症急性期的临床观察

发布时间：2018-05-03 10:22

本文选题：第二代抗精神病药物 + 精神分裂症　；参考：《中国药房》2016年20期

【摘要】：目的:考察4种第二代抗精神病药物治疗精神分裂症急性期的临床疗效及不良反应。方法:将159例精神分裂症患者按照随机数字表法分为利培酮组(40例)、奥氮平组(40例)、阿立哌唑组(39例)和齐拉西酮组(40例),每组患者按常规用法用量给予对应的药物,进行为期6周的临床研究。治疗前和治疗2、4、6周末采用阳性与阴性症状量表对各组患者的精神状况进行评定;同时进行血糖、血脂、泌乳素等代谢和生物学指标检测;并采用锥体外系副反应量表、静坐不能评定量表、精神性不良反应量表评定不良反应。结果:共计137例患者完成研究。利培酮组和奥氮平组对精神症状的控制,尤其是对阳性症状的控制起效快于阿立哌唑组和齐拉西酮组,差异有统计学意义(P0.05)。治疗后,奥氮平组患者的体质量指数和腹围增加数明显大于其他3组,差异均有统计学意义(P0.05);该组患者的低密度脂蛋白也明显增高,与齐拉西酮组和阿立哌唑组比较,差异均有统计学意义(P0.05);利培酮组患者的泌乳素水平明显高于其他3组,阿立哌唑组患者的泌乳素水平明显低于其他3组,差异均有统计学意义(P0.05)。4种药物的不良反应多数为轻度或中度,对症处理后大多可缓解。结论:4种第二代抗精神病药物对精神分裂症急性期精神症状的控制疗效相当,其中利培酮、奥氮平控制阳性症状的起效时间较早,与糖脂代谢和泌乳素有关的不良反应也出现较多;阿立哌唑、齐拉西酮的不良反应相对较少,患者的耐受性较好。用药时应全面考虑各种因素,制订个体化的治疗方案。
[Abstract]:Objective: to investigate the clinical efficacy and adverse reactions of four second-generation antipsychotics in the acute stage of schizophrenia. Methods: 159 patients with schizophrenia were randomly divided into risperidone group (n = 40), olanzapine group (n = 40), aripiprazole group (n = 39) and ziprasidone group (n = 40). A 6-week clinical study was conducted. Before treatment and at the end of 6 weeks after treatment, positive and negative symptom scales were used to assess the mental status of the patients in each group, blood glucose, blood lipid, prolactin and other metabolic and biological indexes were measured, and the extrapyramidal side effects scale was used. Sit-ins could not be rated as a scale, and psychiatric adverse reactions were assessed. Results: a total of 137 patients completed the study. The control of mental symptoms in risperidone group and olanzapine group was faster than that in aripiprazole group and ziprasidone group (P 0.05). After treatment, the body mass index and abdominal circumference of the patients in the olanzapine group were significantly higher than those in the other three groups, and the difference was statistically significant (P 0.05), and the low density lipoprotein in the group was also significantly higher than that in the ziprasidone group and aripiprazole group. The prolactin level in risperidone group was significantly higher than that in the other three groups, and the prolactin level in aripiprazole group was significantly lower than that in the other three groups. All the differences were statistically significant. The adverse reactions of P0.05.4 drugs were mostly mild or moderate, and most of them could be alleviated after symptomatic treatment. Conclusion the control efficacy of the four kinds of second generation antipsychotics against schizophrenia in acute stage is similar, among which risperidone and olanzapine are effective for the control of positive symptoms. There were also more adverse reactions related to glycolipid metabolism and prolactin, and the side effects of aripiprazole and ziprasidone were relatively few, and the patients had better tolerance. All kinds of factors should be taken into account and individualized treatment plan should be formulated.
【作者单位】：新乡医学院第二附属医院/河南省精神卫生中心;
【基金】：国家自然科学基金资助项目(No.81371472) 河南省科技项目(No.124200510019)
【分类号】：R749.3

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