胡艳萍 刘龙平 易双 张小红

摘 要 目的：比較阿立哌唑与利培酮治疗女性精神分裂症的效果和安全性。方法：选择2018年11月-2020年1月收治的女性精神分裂症患者70例，随机分为两组各35例。对照组口服利培酮治疗，初始剂量为1 mg/d，2周内逐步增加至6 mg/d，治疗8周。观察组口服阿立哌唑治疗，初始剂量为5 mg/d，1周内逐步增加至25 mg/d，治疗8周。采用阳性和阴性症状量表（PANSS）、精神分裂症生活质量量表（SQLS）、蒙特利尔认知评估量表（MoCA）和简易精神状态评价量表（MMSE）评估两组患者的认知水平。比较两组治疗效果、安全性及糖脂代谢水平。结果：观察组治疗总有效率为94.29%（33/35），高于对照组的77.14%（27/35，P<0.05）。治疗后，观察组总胆固醇（TC）水平低于对照组（P<0.05），PANSS评分、SQLS评分均低于对照组，MoCA评分、MMSE评分均高于对照组（P<0.05）。观察组焦虑、体重增加、静坐不能、震颤发生率均低于对照组（P<0.05）。结论：阿立哌唑治疗女性精神分裂症效果优于利培酮，对患者血脂代谢影响小，不良反应少。

关键词 精神分裂症；药物治疗；不良反应

中图分类号：R749.3 文献标志码：A 文章编号：1006-1533（2021）10-0025-04

Comparison of the efficacy and safety of aripiprazole and risperidone in the treatment of female schizophrenia

HU Yanping， LIU Longping， YI Shuang， ZHANG Xiaohong

（Third Department of Psychiatry of Xinyu Second Hospital， Xinyu， Jiangxi 338000， China）

ABSTRACT Objective： To compare the efficacy and safety of aripiprazole and risperidone in the treatment of female schizophrenia. Methods： Seventy female schizophrenic patients from November 2018 to January 2020 were selected and randomly divided into two groups with 35 cases in each group. The control group was treated with risperidone， the initial dose was 1 mg/d， which was gradually increased to 6 mg/d within 2 weeks， and the treatment was 8 weeks. The observation group was treated with aripiprazole orally， the initial dose was 5 mg/d， which was gradually increased to 25 mg/d within 1 week， and the treatment was for 8 weeks. Positive and negative symptom scale（PANSS）， schizophrenia quality of life scale（SQL）， Montreal cognitive assessment scale（MoCA） and mini mental state assessment scale（MMSE） were used to evaluate the cognitive level of the two groups. The therapeutic effect， safety and glucose and lipid metabolism of the two groups were compared. Results： The total effective rate was 94.29% （33 / 35） in the observation group， which was higher than 77.14%（27/35） in the control group（P<0.05）. After treatment， TC level in the observation group was lower than that in the control group（P<0.05）， PANSS score and SQL score in the observation group were lower than those in the control group， MoCA score and MMSE score in the treatment group were higher than those in the control group（P<0.05）. The incidence of anxiety， weight gain， akathisia and tremor in the observation group were lower than those in the control group（P<0.05）. Conclusion： Aripiprazole is better than risperidone in the treatment of female schizophrenia， and has little effect on blood lipid metabolism and less adverse reactions.

KEY WORDS schizophrenia； medication； adverse reaction

精神分裂症多表现为亚急性或缓慢发病，患者往往意识清楚，病情反复发作，且迁延难愈，部分患者在发病时存在认知功能损伤情况，严重者会发展为精神残疾[1]。女性是精神分裂症的主要发病人群，需及时采取药物治疗。研究表明，通过药物治疗多数精神分裂症患者能够有效控制病情，但不同药物疗效仍有一定差异[2]。利培酮是治疗该病的常用药物，但长期服用容易造成患者体重增加以及糖代谢异常[3]。阿立哌唑也是治疗精神分裂症的有效药物之一，且不良反应更少[4]。本文报道对上述两种药物治疗女性精神分裂症的效果和安全性进行比较，现报道如下。

1 资料与方法

1.1 一般资料

选择2018年11月-2020年1月收治的女性精神分裂症患者70例，均符合国际疾病分类（ICD-10）[5]中精神分裂症诊断标准。……