【摘要】 目的探讨奥氮平大剂量冲击治疗精神分裂症激越症状的疗效和安全性。方法将84例精神分裂症患者随机分为两组,奥氮平组42例(研究组),20mg·d-1·Po奥氮平大剂量冲击治疗;氟哌啶醇组42例(对照组),10～20mg·d-1·im氟哌啶醇。疗程均为1w。于治疗前及治疗每1d末采用阳性与阴性症状量表中提取的激越因子分评定疗效、副反应量表评定不良反应,评定1次。疗效判定标准:减分率≥75%为痊愈,≥50%为显著进步,≥25%为进步,<25%为无效。结果两组激越因子分在治疗第2d与治疗前比较差异有显著性(P<0.05),第3d开始差异有极显著性(P<0.01);治疗的前5d两组间比较差异无显著性(P>0.05),第6、7d有显著性差异(P<0.05);两组对激越症状均能快速起效,治疗早期疗效相当,治疗后期奥氮平优于氟哌啶醇;奥氮平组显效率为57.1%,有效率为88.1%,氟哌啶醇组显效率为45.2%,有效率为69%。两组有效率差异有显著性(x2=4.53,P<0.05);两组不良反应中EPS发生率有极显著性差异(P<0.01)。结论奥氮平大剂量口服给药治疗精神分裂症激越症状疗效优于肌注氟哌啶醇,且安全性高。更多还原

【Abstract】 Objective To explore the curative effects and safety of large dose of olanzapine in the ictus treatment of agitated symptoms of schizophrenia. Methods 84 schizophrenics were randomly divided into research group (n = 42, large dose of olanzapine 20mg/d po) and control group(n = 42,haloperidol 10-20 mg/d im) for one week. Before treatment and at ends of each day, efficacy and side effects were assessed with the Scale for Assessment of Positive Symptoms(SAPS), Scale for Assessment of Negative Symptoms (SANS) and Treatment Emergent Symptom Scale(TESS) , respectively. Criteria of curative effects: score-reducing rate ≥75% was recovery, ≥50% marked improvement, ≥25% improvement and <25% ineffectiveness. Results Compared to pre-treatment, the scores of agitated factor of both the 2 groups had significant difference in the 2nd day of treatment (P<0. 05) and more significant since the 3rd day(P<0. 01); there was no significant difference in the first five days of treatment(P>0. 05) and was significant difference in 6th and 7th days(P<0. 5) between the 2 groups. Both the 2 groups took effects fast in agitated symptoms, their efficacies were equivalent in the initial stage of treatment, and olanzapine was better than haloperidol in the later stage; effectual and effective rates of olanzapine were respectively 57. 1% and 88. 1%, haloperidol 45. 2%, and 69%, difference of effective rate was significant between the 2 groups (P< 0.05). Incidence rates of extrapyramidal symptoms had more significant difference between the 2 groups (P<0. 01). Conclusion Large dose of olanzapine is better than that of haloperidol( im) in agitated symptoms of schizophrenia and has higher safety.更多还原