奥氮平口溶膜与肌肉注射氟哌啶醇治疗男性精神分裂症激越行为的随机对照研究
Olanzapine oral soluble film versus intramuscular haloperidol for the treatment of acute male schizophrenic patients with agitation: A randomized controlled trial
投稿时间:2024-04-16  修订日期:2024-10-20
DOI:
中文关键词:  奥氮平  口溶膜  氟哌啶醇注射液  精神分裂症  激越
英文关键词:Olanzapine  oral soluble film  haloperidol injection  schizophrenia  agitation
基金项目:
作者单位地址
孙龙龙 阜阳市第三人民医院 安徽省阜阳市颍州区文兴路2号
吴延海 阜阳市第三人民医院 
李叶新 阜阳市第三人民医院 
谭陈晨 阜阳市第三人民医院 
崔舒* 阜阳市第三人民医院 安徽省阜阳市颍州区文兴路2号
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中文摘要:
      背景 男性精神分裂症患者激越行为对个体及社会造成严重影响。非侵入性制剂的给药方式可能有助于快速控制激越,可能改善整体患者体验,但奥氮平口溶膜治疗激越行为的研究有限。目的 比较10 mg/d奥氮平口溶膜与8 mg/d氟哌啶醇对男性精神分裂症患者激越行为改善的效果和安全性,以期为激越行为的治疗提供参考。方法 于2022年5月—2023年7月,在阜阳市第三人民医院男性封闭病房招募符合《精神障碍诊断与统计手册(第5版)》(DSM-5)诊断标准、伴激越行为的精神分裂症患者(n=44)为研究对象。采用随机数字表法分为研究组和对照组各22例,研究组接受奥氮平口溶膜10 mg/d治疗,对照组接受肌肉注射氟哌啶醇8 mg/d治疗。使用阳性和阴性症状量表-兴奋因子(PANSS-EC)和激越-镇静评估量表(ACES)评定治疗前和用药6 h后患者激越行为严重程度,并记录治疗应答率。治疗前和治疗后6小时,使 用锥体外系副反应量表(RSESE)和静坐不能评定量表(BARS)评估药物副作用。结果 用药6h后,两组PANSS-EC评分和ACES评分间的差异无统计学意义(F=0.039,P=0.844;F=0.082,P=0.776),两组治疗应答率之间的差异无统计学意义(χ2=0.419,P=0.517),研究组不良反应发生率低于对照组,差异有统计学意义(χ2=4.659,P=0.031),两组BARS评分比较,差异无统计学意义(F=0.907,P=0.347),研究组RSESE评分低于对照组,差异有统计学意义(F=55.503,P<0.01)。两组均无严重不良反应报告。结论 在治疗精神分裂症患者的激越症状方面,奥氮平口溶膜和肌注氟哌啶醇效果相似,均安全且耐受性良好,而奥氮平口溶膜则在副作用方面表现更佳。
英文摘要:
      Background Agitated behaviour in men with schizophrenia has serious individual and social consequences. Non-invasive formulations of drug delivery may help to rapidly control agitation and may improve the overall patient experience, but there are limited studies of olanzapine orally dissolved film for the treatment of agitated behaviour. Objective To compare the efficacy and safety of 10 mg/d olanzapine orally dissolved film with 8 mg/d haloperidol on the improvement of agitated behaviours in male patients with schizophrenia, with a view to providing a reference for the treatment of agitated behaviours. Methods From May 2022 to July 2023, schizophrenic patients (n=44) with agitated behaviour who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (5th edition) (DSM-5) were recruited in the male closed ward of the Third People's Hospital of Fuyang City, Anhui Province, China. They were divided into 22 cases each in the study group and the control group using the random number table method, and the study group was treated with olanzapine orally dissolved membrane 10 mg/d, while the control group was treated with intramuscular haloperidol 8 mg/d. The severity of agitated behaviour was assessed using the Excited Component of Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation Calmness Evaluation Scale (ACES) pre-treatment and 6 h after administration of the drug. Drug side effects were assessed using the Rating Scale for Extrapyramidal Side Effects (RSESE) and the Barnes Akathisia Rating Scale (BARS) before and 6 hours after treatment. Results After 6h of drug administration, the difference between the PANSS-EC score and ACES score of the two groups was not statistically significant (F=0.039, P=0.844; F=0.082, P=0.776), the difference between the rates of therapeutic response of the two groups was not statistically significant (χ2=0.419, P=0.517), and the incidence rate of adverse reactions was lower than that of the control group in the study group, and the difference was statistically significant (χ2=4.659, P=0.031), there was no statistically significant difference between the BARS scores of the two groups (F=0.907, P=0.347), and the RSESE scores of the study group were lower than those of the control group, with a statistically significant difference (F=55.503, P<0.01). No serious adverse reactions were reported in either group. Conclusions: In the treatment of agitation in patients with schizophrenia, olanzapine orally dissolved film and intramuscular haloperidol are antipsychotics with similar effects, both safe and well tolerated, while olanzapine orally dissolved film performs better in terms of side effects.
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