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[摘要]
目的 探讨不同剂量利培酮片治疗首发精神分裂症的临床疗效及其安全性评价。方法 选择2012年4月—2014年4月北京市房山区精神卫生保健院接受诊治的首发精神分裂症患者127例,随机分为大剂量组(n=62)和小剂量组(n=65)。大剂量组患者给予利培酮片起始剂量为0.5~1 mg/d,第2~3天根据患者病情和不良反应逐渐增加剂量为6 mg/d,维持量为6 mg/d。小剂量组患者给予利培酮片起始剂量为0.5~1 mg/d,第2~3天根据患者病情和不良反应逐渐增加剂量为3 mg/d,维持量为3 mg/d。两组均连续治疗8周。比较两组的临床疗效,并对比分析两组PANSS量表评分、锥体外系反应(EPS)发生情况及副反应量表(TESS)评分。结果 小剂量组患者总有效率为93.85%,大剂量组患者总有效率为82.26%,两组比较差异具有统计学意义(P< 0.05)。治疗后,两组患者阴性症状量表分、阳性症状量表分、精神病理量表分和PANSS总分均显著降低(P< 0.05);小剂量组阴性症状量表分、阳性症状量表分、精神病理量表分及PANSS总分治疗4、8周后均显著低于同期大剂量组,且差异具有统计学意义(P< 0.05)。小剂量组EPS发生率显著低于大剂量组,且差异具有统计学意义(P< 0.05)。小剂量组治疗4、8周TESS评分均显著低于大剂量组,差异具有统计学意义(P< 0.05)。结论 小剂量利培酮片治疗首发精神分裂症小剂量可明显提高疗效、减低PANSS评分、EPS发生少、不良反应少,明显优于大剂量利培酮片。
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[Abstract]
Objective To observe the effect of various dosages of Risperidone Tablets in treatment of first episode schizophrenia and safety evaluation. Methods Patients (127 cases) with first episode schizophrenia from Beijing Fangshan District Mental Health Care Hospital from April 2012 to April 2014 were randomly divided into high-dosage group ( 62 cases) and low-dosage group (65 cases). The patients in the high-dosage group were po administered with Risperidone Tablets 0.5—1 mg/d at beginning, then gradually added to 6 mg/d according to patient's condition and adverse reactions in the second and third day, and maintained the dosage of 6 mg/d. The patients in the low-dosage group were same to those in the high-dosage group except added dosage and maintenance dosage of 3 mg/d. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and PANSS score, EPS occurrence and TESS scores in two groups were compared. Results The efficacies in the high-dosage and low-dosage groups were 93.85% and 82.26%, respectively, and there were differences between two groups (P < 0.05). After treatment, negative symptom scale scores, positive symptom scale score, the psychopathology scale scores, and PANSS total score in two groups were significantly lower, and the difference was statistically significant in the same group (P < 0.05). The observational indexes of the low-dosage group were significantly lower than those in the same period in the high-dosage group treated for 4 and 8 weeks, with significant difference between two groups (P < 0.05). The incidence of EPS and TESS scores at 4 and 8 week in the low-dosage group were obviously lower than those in the high-dosage group, and the difference was statistically significant between two groups (P < 0.05). Conclusion Low-dosage of Risperidone Tablets has curative effect in treatment of first episode schizophrenia with better clinical efficacy, less PANSS score, incidence of EPS, and TESS scores, which be superior to clinical effects of high-dosage of Risperidone Tablets.
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