帕利哌酮缓释片与阿立哌唑治疗首发精神分裂症对照研究杨国平 吴　越　顾　君　汤　莉　季　萍【摘要】　目的　探讨帕利哌酮缓释片治疗首发精神分裂症的疗效和安全性。

方法　60例符合CCM D-3诊断标准的首发精神分裂症患者随机分为两组,分别予帕利哌酮缓释片(治疗组)和阿立哌唑(对照组)治疗,共8周,采用阳性症状和阴性症状量表(PA N SS)评定疗效,副作用量表(T ESS)评定副反应。

结果　治疗8周两组疗效相当,治疗组有效率90%,对照组有效率83.3%,差异无显著性,但治疗组4周时阳性因子分即明显下降,较对照组有显著差异(t=3.99,P<0.05);治疗组8周时阴性因子分较治疗前显著下降,较对照组有显著差异(t=5.97,P<0.05)。

结论　帕利哌酮缓释片和阿立哌唑对首发精神分裂症疗效相当,帕利哌酮缓释片起效快,并且对阴性症状有较好的疗效,安全性高。

【关键词】　精神病学;帕利哌酮缓释片;阿立哌唑;首发精神分裂症Control Study on Paliperidone and Aripiprazole in the Treatment of First-episode Schizophrenia.Yang Guop ing,W u Y ue,Gu J un,et al.D ep ar tment of Senile Psy chiatr y,W ux i M ental H ealth Center,W ux i214151,P.R.China【Abstract】　Objective　T o invest igate the efficacy and safety o f paliper ido ne in the t reatment of first-episode schizophrenia.Meth-ods　A total o f60cases met the CCM D-3criteria for first-episode schizophr enia were divided int o two gr oups r andomly,treated w ith paliper ido ne and ar ipipr azole respectively for8w eeks.T he Positiv e and N egativ e Sy ndrom e Scale(PA N SS)and T r eatment E-mergent Symptom Scale(T ESS)w ere used to access the therapeutic efficacy and side effects respectively.Results　P aliper idone w as as effective as ar ipipr azole fo r the treatment of fir st-episo de schizophr enia(P>0.05),the effectiv e r ate w as90%in tr eatm ent gr oup and83.3%in contr ol gr oup.there was no significant difference betw een tw o g ro ups in significant impr ovement r ate.How ev-er,from4w eeks positive factor point s in the treatment g roup w as decr eased sig nificantly(t=3.99,P<0.05),and negative factor po ints in the treatment gr oup w as decreased at8w eeks,there w as a sig nificant differ ence t han control gro up(t=5.97,P<0.05). Conclusion　P aliper idone is as effective as ar ipipr azole in the treatment of fir st-episo de schizophrenia.Ho wever,it has much better effect for the neg ative sy mptoms,and has hig her safety.【Key words】　Psychiatry;P aliper idone;A ripipr azo le;F irst-episode schizophrenics 国内外已有多位学者认为帕利哌酮缓释片治疗首发精神分裂症起效快且安全性高。

在临床使用中同时发现帕利哌酮缓释片能有效预防复发。

本文对帕利哌酮缓释片与阿立哌唑治疗首发精神分裂症的疗效对照进行研究。

精神分裂症病程迁延,致残率高,尤其是阴性症状严重影响患者的工作、学习、社交功能,传统抗精神病药物及一些新型抗精神病药对阴性症状疗效不明显,因此对阴性症状的治疗一直是精神科领域的难点。

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1周内未服抗精神病药,符合CCM D-3精神分裂症诊断标准,年龄18～56岁。

阳性症状和阴性症状量表(P A NSS)>60分,无重大躯体疾病,无药物依赖和酒依赖,无妊娠和哺乳者,征得家属同意。

按入院时间随机分为治疗组(帕利哌酮缓释片,生产企业:AL ZA Co rpo ratio n,商品名芮达)。

对照组(阿立哌唑,生产企业:上海中西医药有限公司,商品名奥派)。

治疗组30例,男18例,女12例,年龄19～56岁,平均(30.1±8.9)岁;对照组30例,男17例,女13例,年龄18～57岁,平均(29.9±9.2)岁。

两组性别、年龄、文化程度、病程及诊断亚型均无显著性。

两组基线的P A N SS总分及各因子分也无显著性差异。

1.2　方法　帕利哌酮缓释片起始剂量3mg/d,最大剂量12mg/d,平均剂量(6±3.25)mg/d。

阿立哌唑起始剂量5mg/ d,2周后加至15mg/d,最大剂量30mg/d,平均剂量(10±5.22)mg/d。

焦虑、失眠者短程合用艾司唑仑片1～2mg qn。

有锥体外系副反应EP S者并用安坦2mg bid。