目的 探討不同劑量利培酮片治療首發(fā)精神分裂癥的臨床療效及其安全性評(píng)價(jià)。方法 選擇2012年4月—2014年4月北京市房山區(qū)精神衛(wèi)生保健院接受診治的首發(fā)精神分裂癥患者127例,隨機(jī)分為大劑量組(n＝62)和小劑量組(n＝65)。大劑量組患者給予利培酮片起始劑量為0.5～1 mg/d,第2～3天根據(jù)患者病情和不良反應(yīng)逐漸增加劑量為6 mg/d,維持量為6 mg/d。小劑量組患者給予利培酮片起始劑量為0.5～1 mg/d,第2～3天根據(jù)患者病情和不良反應(yīng)逐漸增加劑量為3 mg/d,維持量為3 mg/d。兩組均連續(xù)治療8周。比較兩組的臨床療效,并對(duì)比分析兩組PANSS量表評(píng)分、錐體外系反應(yīng)(EPS)發(fā)生情況及副反應(yīng)量表(TESS)評(píng)分。結(jié)果 小劑量組患者總有效率為93.85%,大劑量組患者總有效率為82.26%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療后,兩組患者陰性癥狀量表分、陽性癥狀量表分、精神病理量表分和PANSS總分均顯著降低(P< 0.05);小劑量組陰性癥狀量表分、陽性癥狀量表分、精神病理量表分及PANSS總分治療4、8周后均顯著低于同期大劑量組,且差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。小劑量組EPS發(fā)生率顯著低于大劑量組,且差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。小劑量組治療4、8周TESS評(píng)分均顯著低于大劑量組,差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 小劑量利培酮片治療首發(fā)精神分裂癥小劑量可明顯提高療效、減低PANSS評(píng)分、EPS發(fā)生少、不良反應(yīng)少,明顯優(yōu)于大劑量利培酮片。

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.