奥氮平与利培酮治疗精神活性物质致精神障碍的疗效及安全性对照研究

目的：评价奥氮平和利培酮治疗精神活性物质所致精神障碍的疗效及安全性，为因精神活性物质所致精神障碍患者用药提供依据。方法：采用区组随机方法将107例因精神活性物质致精神障碍的患者分为两组，分别予以奥氮平片和利培酮片治疗。应用阴阳性症状评定量表（PANSS）、评定治疗副反应量表（TESS）、空腹体重，血常规、血生化、心电图检查进行疗效和安全性评价。结果：两组PANSS在治疗2周末，总分值均有下降，并随着治疗时间的延续而明显下降，至6周末，同组比较总分差异均有统计学意义（P〈0．01）；两组间比较差异无统计学意义（P〉0．05）。对3种精神活性物质的治疗效果比较，两组间总分和减分率差异均无统计学意义（P〉0．05）；同组间在6周末与基线比较，均有统计学意义（P〈0．01）；安全性分析提示，奥氮平组BMI增加值、三酰甘油值高于利增酮组，差异有统计学意义（P〈0．05）。结论：奥氮平和利培酮治疗精神活性物质所致的精神障碍均有良好的效果．安全性较好。但在临床治疗应用中，要结合患者的临床特点和个体差异选择用药。

Comparison of Curative Effect and Safety of Olanzapine and Risperidone on the Treatment of Psychogeny Induced by Psychoactive Substances

Objective：To investigate the curative effect and safety of olanzapine and risperidone on the treatment of psychogeny induced by psychoactive substances inclusive of herion, smokable methamphetamine, ecstasy and ketamine in this study, nethods：107 patients with psychogeny were randomized into two groups treated with olanzapine or risperi-done by randomized block design. The clinical results were evaluated mainly by the Positive and Negative Syndrome Scale for schizophrenia （PANSS） and the Treatment Emergent Symptom Scale （TESS）. Their body weight, blood RT, the blood biochemistry and ECG examination were also used to evaluate the curative effect and safety. Results： At the end of 2 weeks of the treatment, the total score values had a decrease for the two groups in PANSS, and significantly declined with the con- tinuation of treatment time. At the end of 6 weeks, the total score difference within the same group had its statistical signifi- cance（P 〈0.01 ）, but the total score difference between the two groups has no statistical significance （P 〉0.05）. The comparison of active material and the total score and points rate difference between the two groups had no statistical signifi- cance（P 〉 0.05） for 4 kinds of mental treatment effect. At 6th weekend, the comparison of the baseline between the groups had statistical significance （P 〈 0.01 ）. Security analysis suggested its statistical significance （ P 〈 0.05 ） in the drowsiness and dry mouth of the olanzapine group and the added value of BMI and three acyl glycerin.value higher than those of risperidone group had the statistically significant difference （ P 〈 0.05 ）. Conclusion： Our results suggested that either olanzapine or risperidone was efiective and safe in the treatment of psychogeny induced .by some psychoactive sub-stances. To achieve better treatment effects and few side effects of olanzapine or risperidone, the patient＇ s clinical charac-teristics and individual difference should be, taken into consideration.