韩莉 刘义 毛洪京 孙丽君

[摘要] 目的 对比分析奥氮平和阿立哌唑对精神分裂症患者的疗效和不良反应。 方法 选择200例精神分裂症患者随机分为两组，AR组患者予口服阿立哌唑治疗，OL组患者予口服奥氮平治疗，两组均治疗8周，对比分析两组疗效情况。 结果 治疗8周后，AR组总有效率86.00%，与OL组的88.00%比较，差异无统计学意义（P>0.05）；两组治疗后阳性症状、阴性症状、一般病理评价及PANSS总分均显著低于治疗前（P<0.05）；OL组治疗8周后各指标水平均显著高于治疗前（P<0.05）；OL组治疗4周和8周后甘油三酯（TG）、胆固醇（TC）水平均显著高于AR组（P<0.05）；OL组治疗8周后空腹血糖浓度（FBS）、胰岛素水平（INS）、胰岛素抵抗指数（IR）、体重指数（BMI）水平显著高于AR组（P<0.05）；AR组不良反应发生率显著高于OL组，差异有统计学意义（33.00% vs 11.00%，P<0.05）。 结论 阿立哌唑能显著改善精神分裂症的临床症状，对血糖代谢的影响较小，但不良反应发生率较高；奥氮平治疗精神分裂症的疗效确切，不良反应较少，但会导致胰岛素抵抗作用增强，影响机体血糖代谢。

[关键词] 奥氮平；阿立哌唑；精神分裂症

[中图分类号] R749.3 [文献标识码] B [文章编号] 1673-9701（2015）34-0077-04

Comparative analysis of olanzapine and aripiprazole on schizophrenia clinical efficacy and adverse reactions of patients

HAN Li LIU Yi MAO Hongjing SUN Lijun

Department of Psychology， the Seventh People's Hospital of Hangzhou in Zhejiang Province， Medical College of Zhejiang University Mental Health Center， Hangzhou 310013， China

[Abstract] Objective To compare the effect of olanzapine and aripiprazole on schizophrenia patients and adverse reactions. Methods A total of 200 patients with schizophrenia were randomly divided into two groups. AR group were treated with oral aripiprazole. OL group were treated with oral olanzapine treatment. Two groups were treated for 8 weeks， the efficacy of the two groups were analyzed. Results After 8 weeks of treatment， the total effective rate of AR group and OL group was 86.00% and 88.00%， the difference was not statistically significant（P>0.05）. The positive symptoms， negative symptoms， general pathologic evaluation and PANSS total scores of the two groups were significantly lower than those of the treatment before treatment（P<0.05）. The index level of OL group after 8 weeks were significantly higher than before treatment （P<0.05）. The levels of triglyceride （TG） and cholesterol （TC） were significantly higher in OL group than in AR group（P<0.05） after 4 weeks and 8 weeks. Fasting blood glucose concentration （FBS）， insulin resistance index （INS）， insulin resistance index （IR） and body mass index （BMI） were significantly higher in OL group than in AR group（P<0.05） at 8 weeks after treatment. The incidence of adverse reactions in AR group was significantly higher than that in OL group（33.00% vs 11.00%）， the difference was statistically significant（P<0.05）. Conclusion Aripiprazole can schizophrenia significantly improve the clinical symptoms， has less effect on glucose metabolism， but adverse reactions occurred rate is higher. Olanzapine in treatment of mental division disease curative effect， less adverse reaction， but will lead to insulin resistance， enhance， affecting the body's blood sugar metabolism.

[Key words] Olanzapine； Aripiprazole； Schizophrenia

精神分裂症为常见精神病，患者常伴有行为、情感、思维等多方面障碍。目前改变的发病机制尚未完全明了，有研究结果表明，其心理、环境、遗传、社会、个性等多种因素相关[1]。近年来临床治疗精神分裂症的主要药物为第二代非典型抗精神病药，随着药物的广泛运用，临床出现了体重显著增加、糖脂代谢紊乱等并发症[2]。抗精神病药物对精神分裂症患者代谢水平的影响成为精神科医师普遍关注的焦点，而目前临床对这方面系统性的研究较少[3]。故本研究对我院收治的200例精神分裂症患者采用奥氮平和阿立哌唑治疗，比较两组疗效情况。现报道如下。

1 资料与方法

1.1 一般资料

选取2012年3月～2014年11月我院门诊或住院收治的精神分裂症患者200例，全部患者由2位精神科主治医师确诊且符合美国DSMIV中相关诊断标准[4]。按序列号法随机分为两组：AR组100例，男64例，女36例，年龄23～56岁，平均（37.91±6.36）岁，病程10个月～5年，平均（3.12±1.86）年，42例有家族病史；OL……