【摘要】 目的:观察齐拉西酮联合奥氮平治疗老年难治性精神分裂症的疗效和安全性。方法:120例老年精神分裂症患者随机分为对照组和研究组。对照组患者给予奥氮平片10~20 mg,口服,每日1次;研究组患者给予盐酸齐拉西酮胶囊80~120 mg,口服,每日2次+奥氮平片(用法同对照组)。观察两组患者用药12周后的临床疗效,治疗前后阳性和阴性症状量表(PANSS)总评分、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、体质量、体质量指数(BMI)及不良反应发生情况。结果:两组患者总有效率、不良反应发生率比较,差异均无统计学意义(P>0.05)。治疗后,两组患者PANSS总评分均显著低于同组治疗前,且12周<8周<4周<2周,差异均有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。研究组患者治疗前后血糖指标、血脂指标、体质量、BMI比较,差异均无统计学意义(P>0.05);对照组患者治疗8、12周后的血糖指标,治疗4、8、12周后LDL-C、TG、TC、体质量、BMI均显著高于同组治疗前及研究组同期,HDL-C均显著低于同组治疗前及研究组同期,差异均有统计学意义(P<0.05)。结论:齐拉西酮联合奥氮平与单用奥氮平治疗老年难治性精神分裂症的疗效和安全性均相当,但联合用药在糖脂代谢影响方面小于单用奥氮平。更多还原

【Abstract】 OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refractory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treated with Ziprasidone hydrochloride capsule 80-120 mg,twice a day + Olanzapine tablet(the usage was the same as control group).The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight,BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were statistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not significant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment(P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olanzapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar,however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.更多还原