奎硫平联合碳酸锂治疗双相躁狂对照研究_临床医学论文.docVIP

奎硫平联合碳酸锂治疗双相躁狂对照研究_临床医学论文 奎硫平联合碳酸锂治疗双相躁狂对照研究_临床医学论文 作者：张蓉 赖玉兰 叶郁葱 邬德纯【摘要】 目的 探讨奎硫平联合碳酸锂治疗双相躁狂的临床疗效及安全性。 方法 将70例双相障碍躁狂发作患者随机分为两组各35例，研究组给予奎硫平联合碳酸锂治疗，对照组给予氯丙嗪联合碳酸锂治疗；观察6 w。于治疗前及治疗2 w、6 w末应用Beck躁狂量表及副反应量表评定临床疗效和不良反应。 结果 治疗6 w末，研究组显效率88.2%、有效率97.1%；对照组分别为84.8%、96.9%。两组比较均无显著性差异（P＞0.05）。Beck躁狂量表评分，治疗2 w末起两组均较治疗前有显著性下降（P＜0.01），并随着治疗时间的延续均呈持续性下降，但研究组治疗2 w末较对照组下降显著（P＜0.05），6 w末无显著性差异（P＞0.05）；研究组不良反应总发生率显著低于对照组(χ2=4.06，P＜0.05)。结论 奎硫平联合碳酸锂治疗双相躁狂，疗效显著、起效快、安全性高、依从性好，值得临床推广应用。 【关键词】 奎硫平；碳酸锂；情感稳定剂；双相躁狂 　　【Abstract】 Objective To explore the curative effects and safety of quetiapine combined with lithium carbonate in the treatment of bipolar mania. Methods 70 bipolar mania patients were randomly divided into research group（n=35） treated with quetiapine plus lithium carbonate and control group（n= 35） with chlorpromazine plus lithium carbonate for 6 weeks. Curative effects were assessed with the BeckRafaelsen Mania Rating Scale（BRMS） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of the 2nd and 6th week. Results After 6 week treatment，excellence and effectiveness rates were 88.2% and 97.1% in the research and 84.8% and 96.9% in the control group respectively，which showed no significant differences（Pgt;0.05）. The BRMS scores of both two groups lowered more significantly since the end of the 2nd week compared with pre（0.01） and did contiously along with the time of therapy lasting，and so did in the research than in the control group at the end of the 2nd week（0.05） and there was no significant difference between the 2 groups at the end of the 6th week（Pgt;0.05）；incidences of adverse reactions were significantly lower in the research than in the control group（0.05）. Conclusion Quetiapine combined with lithium carbonate has evident effect, higher safety and better compliance and takes effects faster in bipolar mania. 　　【Keywords】 Quetiapine；lithium carbonate；mood stabilizer；bipolar mania 　　双相障碍（Bipolar disorder）也称双相情感障碍，是指既有躁狂或轻躁狂