目的 比较阿立哌唑与齐拉西酮治疗首发精神分裂症患者的疗效和安全性.方法 对103例符合CCMD-3精神分裂症诊断标准的首发精神分裂症患者采用随机、双盲的方法分为阿立哌唑组51例和齐拉西酮组52例,分别应用阿立哌唑和齐拉西酮治疗10周.分别于入组前、2周末、6周末、10周末,采用PANSS、CGI量表评定疗效,应用TESS量表评定副反应.结果 治疗10周后,两组疗效及副反应比较均无显著性差异(P＞0.05).阿立哌唑组恶心呕吐、头痛的发生率比齐拉西酮组多(P＜0.05,P＜0.01),齐拉西酮组口干、食欲减退或厌食比阿立哌唑组多(P＜0.05).两组锥体外系反应不明显,较少引起体重增加和月经紊乱,未发现溢乳现象.结论 阿立哌唑和齐拉西酮对首发精神分裂症疗效相当,副反应较轻,副反应表现略有差异.两种药物均疗效好、安全性高,对体重和月经影响较小,无溢乳,有利于提高精神分裂症患者服药的依从性.%Objective To compare the efficacy of aripiprazole and ziprasidone in treatment for patients with schizophrenia. Methods A total of 103 patients with first-episode schizophrenia were randomly and double-blindedly divided into aripiprazole group (51 cases) and ziprasidone group (52 cases) for 10-week treatment. All patients were assessed with Positive and Negative Symptom Scale ( PANSS) , Clinical Global Impression Scale ( CGI) , Treatment Emergent Symptom Scale (TESS) at the baseline and at the 2nd, 6th, 10th weekend of the treatment to evaluate the efficacy and side effects. Results There was no significant difference in efficacy between the two groups at the end of the treatment ( P > 0. 05 ). The incidence rate of nausea and vomitting ( P < 0. 05 ), headache ( P < 0. 01) in aripiprazole group were significantly higher than those in ziprasidone group. Incidence rate of dry mouth, anorexia in ziprasidone group were significantly higer than those in aripiprazole group ( P < 0. 05 ). There were no serious extrapyramidal symptoms (EPS) , weight gain and menstrual disorder in the two groups. Lactation was not found during the treatment in both groups. Conclusion The efficacy of aripiprazole is equivalent with ziprasidone in the treatment of schizophrenia. The side effects are different between the two antipsychotics, but all the side effects are mild. The two antipsychotics have littele effect on body weight and endocrine.
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