| | | 阿立哌唑与氯氮平治疗首发精神分裂症对照研究
| | 临床医学毕业论文【关键词】 首发精神分裂症；阿立哌唑；氯氮平；潘氏量表；副反应量表
【摘要】 目的临床医学毕业论文 探讨阿立哌唑治疗首发精神分裂症的临床医学毕业论文疗效及安全性。 方法 将74例首发精神分裂症患者随机分为研究组（阿立哌唑组）36例、对照组（氯氮平组）38例。疗程8 w。采用潘氏量表、副反应量表评定临床疗效和不良反应。结果 治疗8 w末研究组总有效率83.33%，对照组81.58%，两组疗效相当。潘氏量表评分两组间同期比较无显著性差异（P＞0.05）；组内治疗前后比较均有极显著性差异（P<0.01）。研究组认知功能、阴性症状改善优于对照组（P<0.05），且不良反应发生率亦显著低于对照组。 结论 阿立哌唑治疗首发精神分裂症疗效与氯氮平相当，但对于认知功能、阴性症状的改善优于氯氮平，且安全性、依从性较好。
【关键词】 首发精神分裂症；阿立哌唑；氯氮平；潘氏量表；副反应量表
A control study of aripirazole and clozapine in the treatment of firstepisode schizophrenia
【Abstract】 Objective To explore the curative effects and safety of aripiprazole in the treatment of firstepisode schizophrenia. Methods 74 patients with firstepisode schizophrenia were randomly divided into research(n=36, took aripiprazole ) and control(n=38,did clozapine) for 8 weeks. Curative effects were assessed with the Positive and Negative Syndrome Scale(PANSS) and adverse reactions with the Treatment Emergent Symptom Scale(TESS), respectively. Results At the end of the 8th week, total rates were 83.33% in the research and 81.58% in the control group, which showed therapeutic equivalence. In corresponding period score of the PANSS had no difference between the 2 groups(P>0.05); intragroup comparisons showed very significant difference between pre and posttreatment(P<0.01). Improvements of cognitive function and negative symptoms were more significant(P<0.05) and incidence of adverse effects lower in the research than in the control group. Conclusion Aripirazole has therapeutic equivalence to clozapine in firstepisode schizophrenia, significantly improves cognitive function and negative symptoms and has higher safety and better compliance.
【Keywords】 Firstepisode schizophrenia; ariprazole；clozapine；the PANSS; the TESS
阿立哌唑是喹诺啉酮的衍生物，是新一代非典型抗精神病药物，主要通过对D2和5羟色胺1A（5HT1A）受体的部分激动作用以及对5HT2A受体的拮抗作用而共同起效［1］，能有效改善精神分裂症患者的阳性、阴性症状和认知功能，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。为探讨阿立哌唑治疗首发精神分裂症的疗效及安全性，我们与氯氮平进行了对照研究，现将结果报告如下。
1 对象与方法
1.1 对象 选取2004年8月1日～2005年10月31日在我院住院的74例首发精神分裂症患者为研究对象。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）首次发病，年龄15 a～40 a，性别不限；（3）入组前未服用任何抗精神病药；（4）潘氏量表（PANSS）总分≥60分。排除标准：（1）儿童、妊娠期及哺乳期妇女；（2）伴有严重脑、心、肝、肾脏等躯体疾病、血液病、肿瘤或青光眼患者。
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