利培酮与奥氮平治疗酒精所致精神和行为障碍的临床研究(1)
摘 要：目的 探讨利培酮和奥氮平对酒精所致精神和行为障碍的疗效及安全性。方法 选取2016年7月～2017年6月本院收集94例酒精所致精神和行为障碍患者，随机分为利培酮组和奥氮平组，各47例，分别给予利培酮和奥氮平治疗8周。用简明精神病评定量表(BPRS)评定疗效，治疗中出现的症狀量表(TESS)评定不良反应。结果 两组完成8周的治疗，有效率、临床治愈率对比无差异，不存在统计学意义(P>0.05)。不良反应中锥体外系反应(EPS)利培酮组高于奥氮平组，过度镇静奥氮平组高于利培酮组，具有统计学意义(P<0.05)，其余不良反应无差异。结论 利培酮与奥氮平治疗酒精所致精神和行为障碍疗效相似，但奥氮平过度镇静的不良反应更明显，利培酮锥体外系反应的不良反应也不容忽视。
关键词：酒精所致精神和行为障碍；奥氮平；利培酮
中图分类号：R749.62 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.03.048
, http://www.100md.com
文章编号：1006-1959(2018)03-0137-03
Abstract：Objective To investigate the efficacy and safety of risperidone and olanzapine in the treatment of alcohol-induced mental and behavioral disorders.Methods 94 patients with mental and behavioral disorders induced by alcohol were collected from July 2016 to June 2017.They were randomly divided into risperidone group(n=47)and olanzapine group(n=47).They were treated with risperidone and olanzapine for 8 weeks respectively.The efficacy was evaluated by(BPRS)，and adverse reactions were assessed by symptom scale(TESS).Results There was no difference in the effective rate and the clinical cure rate between the two groups after 8 weeks of treatment.There was no statistical significance(P>0.05).Extrapyramidal response(EPS)was higher in risperidone group than in olanzapine group，and the excessive sedation of olanzapine group was higher than that of risperidone group，with statistical significance(P<0.05)，the remaining adverse reactions no difference.Conclusion Risperidone is similar to olanzapine in the treatment of alcohol-induced mental and behavioral disorders.However，the adverse effects of olanzapine over sedation were more obvious，and those of risperidone extrapyramidal reaction could not be ignored.
, http://www.100md.com
Key words：Alcohol induced mental and behavioral disorders；Olanzapine；Risperidone
酒精所致精神和行为障碍包括酒精所致的幻觉症、酒精所致的嫉妒妄想、科萨科夫精神病、Wernicke病或Wernicke脑病、酒精所致的痴呆、酒精所致的心境障碍[1]。利培酮和奥氮平均属于第二代抗精神病药物。精神科治疗精神病性症状时两种药物在均作为首选，选取2016年7月～2017年6月在我院物质依赖病房住院患者，以两种药治疗酒精所致精神和行为障碍，对治疗效果和药物不良反应，报告如下。
1资料与方法
1.1一般资料 选取2016年7月～2017年6月在我院物质依赖病房住院患者，符合精神与行为障碍分类(ICD-10)酒精所致精神和行为障碍诊断标准；存在明显的嗜酒史；长期饮酒后首次出现精神和行为症状；对利培酮和奥氮平无过敏；简明精神病评定量表(BPRS)18项评分≥35分；排除使用其他精神活性物质所致精神和行为障碍、对利培酮和奥氮平过敏者、危重躯体疾病者、绝对卧床者；首次接触抗精神病药。本次研究共纳入94例，随机分为利培酮组和奥氮平组各47例，利培酮组脱落3例，躯体疾病恶化中断治疗1例，锥体外系反应1例，QTC间期延长1例，最终入组44例，男43例，女1例；年龄28～61岁，平均年龄(46.55±6.74)岁；嗜酒时间8～41年，平均嗜酒时间(21.49±4.17)年；BPRS总分平均(77.16±11.98)分。奥氮平组脱落6例，其中因躯体疾病恶化中断治疗2例，过度镇静4例，最终入组41例均为男性；年龄30～62岁，平均年龄(47.02±7.89)岁；嗜酒时间10～40年，平均嗜酒时间(23.14±5.05)年；BPRS总分平均(76.12±9.68)分。以上两组一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(蔡枫 姚雪阳)
关键词：酒精所致精神和行为障碍；奥氮平；利培酮
中图分类号：R749.62 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.03.048
, http://www.100md.com
文章编号：1006-1959(2018)03-0137-03
Abstract：Objective To investigate the efficacy and safety of risperidone and olanzapine in the treatment of alcohol-induced mental and behavioral disorders.Methods 94 patients with mental and behavioral disorders induced by alcohol were collected from July 2016 to June 2017.They were randomly divided into risperidone group(n=47)and olanzapine group(n=47).They were treated with risperidone and olanzapine for 8 weeks respectively.The efficacy was evaluated by(BPRS)，and adverse reactions were assessed by symptom scale(TESS).Results There was no difference in the effective rate and the clinical cure rate between the two groups after 8 weeks of treatment.There was no statistical significance(P>0.05).Extrapyramidal response(EPS)was higher in risperidone group than in olanzapine group，and the excessive sedation of olanzapine group was higher than that of risperidone group，with statistical significance(P<0.05)，the remaining adverse reactions no difference.Conclusion Risperidone is similar to olanzapine in the treatment of alcohol-induced mental and behavioral disorders.However，the adverse effects of olanzapine over sedation were more obvious，and those of risperidone extrapyramidal reaction could not be ignored.
, http://www.100md.com
Key words：Alcohol induced mental and behavioral disorders；Olanzapine；Risperidone
酒精所致精神和行为障碍包括酒精所致的幻觉症、酒精所致的嫉妒妄想、科萨科夫精神病、Wernicke病或Wernicke脑病、酒精所致的痴呆、酒精所致的心境障碍[1]。利培酮和奥氮平均属于第二代抗精神病药物。精神科治疗精神病性症状时两种药物在均作为首选，选取2016年7月～2017年6月在我院物质依赖病房住院患者，以两种药治疗酒精所致精神和行为障碍，对治疗效果和药物不良反应，报告如下。
1资料与方法
1.1一般资料 选取2016年7月～2017年6月在我院物质依赖病房住院患者，符合精神与行为障碍分类(ICD-10)酒精所致精神和行为障碍诊断标准；存在明显的嗜酒史；长期饮酒后首次出现精神和行为症状；对利培酮和奥氮平无过敏；简明精神病评定量表(BPRS)18项评分≥35分；排除使用其他精神活性物质所致精神和行为障碍、对利培酮和奥氮平过敏者、危重躯体疾病者、绝对卧床者；首次接触抗精神病药。本次研究共纳入94例，随机分为利培酮组和奥氮平组各47例，利培酮组脱落3例，躯体疾病恶化中断治疗1例，锥体外系反应1例，QTC间期延长1例，最终入组44例，男43例，女1例；年龄28～61岁，平均年龄(46.55±6.74)岁；嗜酒时间8～41年，平均嗜酒时间(21.49±4.17)年；BPRS总分平均(77.16±11.98)分。奥氮平组脱落6例，其中因躯体疾病恶化中断治疗2例，过度镇静4例，最终入组41例均为男性；年龄30～62岁，平均年龄(47.02±7.89)岁；嗜酒时间10～40年，平均嗜酒时间(23.14±5.05)年；BPRS总分平均(76.12±9.68)分。以上两组一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(蔡枫 姚雪阳)