以risperidone 或olanzapine分別治療精神分裂症之評估

The evaluations of risperidone and olanzapine in the treatment of schizophrenia disorders

張淑玲(Shu-Ling Chang)

指導教授 ： 溫燕霞

高雄醫學大學/藥學院/藥學研究所碩士在職專班/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00107

摘要

背景：本研究藉由統計分析單純以risperidone 或olanzapine 治療
之精神分裂症住院患者，觀察兩藥品在療效與安全性方面的不同，同
時也探討兩藥品在藥費上之差異。材料與方法：本研究之相關數據取自南部某醫學中心健保申報資料庫，屬回溯性分析。均為因精神分裂症而住院的病人，樣本數為147 人，其中119 人單純以risperidone 治療精神分裂症，其餘28 人則只以olanzapine 治療。相關數據收集時間為2005 年7 月1 日至2006年6 月30 日。並持續追蹤每位病人出院後六個月及十二個月內的再住院率。本研究分別以Chi-square、 ANOVA 及Independent t-test 等統計方法進行分析。藉分析每次住院平均總藥費、每日定義劑量比值觀察兩藥品之費用差異。藉分析住院天數及再住院率觀察兩藥品之有效性差異。由併用藥品品項總數、類別與細項觀察兩藥品之安全性差異。結果：每日定義劑量比值兩組不具統計上的顯著差異性。risperidone 每次住院平均總藥費顯然較olanzapine 低。出院後六個月內的再住院率具統計上顯著差異，
risperidone的再住院率顯然較高，而十二個月內的再住院率兩組則沒有差異。risperidone 在總住院天數方面顯然較olanzapine 少。併用品項總數兩者皆以2 項為最普遍。兩藥品在antitussives, expectorants and mucolytic agents 和smooth muscle
relaxants 兩大類的併用方面具有顯著意義，其中olanzapine 併用機率大於risperidone。另外在併用藥品細項方面，risperidone 只有併用trihexyphenidyl 比olanzapine 多，其他藥品則均以
olanzapine較多，即olanzapine 併用藥品的情況比risperidone 頻繁。結論：本研究發現在住院天數及藥費方面，risperidone 是較好的選擇。而出院後六個月內的再住院率及併用trihexyphenidyl 的情況則傾向於選擇olanzapine。

關鍵字

精神分裂症

並列摘要

Background: To compare the effectiveness and safety with schizophrenia inpatients who take risperidone or olanzapine only and with consideration their cost saving. Methods: In retrospective study, 147 inpatients with single therapy, 119of them took risperidone and the others accepted olanzapine in Chang Gung Memorial Hospital - Kaohsiung Medical Center in Taiwan from July 1 2005 to June 30 2006. They were
enrolled and continually follow-up in 6-month and 12-month periods after discharged from the hospital.Chi-square, ANOVA and Independent t-test tests were used to evaluate two medicines and their outcomes.Results: After analyzing two groups, 119 inpatients who took risperidone were hospitalized shorter than 28 inpatients who were treated of olanzapine. The hospital days of risperidone and olanzapine were 22.4 ± 14.1 days vs. 29.0 ± 19.6 days (p<0.05), respectively.The defined daily dose ratios (DDD ratios) were non-significant differences (p≧0.05) between two groups. The total payments of medications, risperidone was found lower than olanzapine (6,081.9 ± 622.0 NTD vs. 9,716.5 ± 1,617.6 NTD, p<0.05). 6-month readmission rate after discharge, olanzapine was lower than risperidone (0.04 ± 0.189 vs. 0.18 ± 0.465, p<0.05), but 12-month readmission rate after discharge was non-significant difference between two groups (p ≧ 0.05). In the combination therapies, two classification medicines were used the most common between two groups. Antitussives, expectorants and mucolytic agents in olanzapine group were more obvious than risperidone group, but smooth muscle relaxants were same between two groups. Besides, for the individual items of combination therapies, only trihexyphenidyl was common in risperidone group.Conclusion: In our study, hospital days and drug cost saving are favored risperidone. 6-month readmission rates and a little trihexyphenidyl
combination are favored olanzapine.

並列關鍵字

Schizophrenia ； risperidone ； olanzapine

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