摘要目的 比较碳酸锂基础上分别加用丙戊酸钠与喹硫平对双相情感障碍躁狂发作患者Bech-Rafaelsen躁狂量表(BRMS)评分、阳性和阴性症状量表(PANSS)评分及不良反应的影响.方法 研究对象选取双相情感障碍躁狂发作患者共100例,采用随机数字表法分为A组(50例)和B组(50例),在碳酸锂基础上分别加用丙戊酸钠与喹硫平治疗;比较两组患者临床疗效,治疗前后BRMS评分、PANSS评分、威斯康星片分类测验(WCST)评分及不良反应发生率等.结果 两组总有效率(94.00%比90.00%),差异无统计学意义(χ2=1.31,P>0.05);B组治疗后2周BRMS评分、PANSS评分及WCST评分均显著优于A组及治疗前,差异均有统计学意义(t=2.45、3.16、2.71、3.26、2.79、3.36,均P<0.05);但两组治疗后6周BRMS评分、PANSS评分及WCST评分差异均无统计学意义(t=1.20、1.08、1.19,均P>0.05);两组不良反应发生率差异无统计学意义(χ2=1.49,P>0.05).结论 两种二联药物方案治疗双相情感障碍躁狂发作总体疗效和安全性较为接近,但喹硫平联合碳酸锂方案应用起效更为迅速,有助于提高治疗依从性.

abstractsObjective To investigate the influence of magnesium valproate and quetiapine separately combined with lithium carbonate on BRMS scores,PANSS scores and adverse effects of patients with manic episode of bipolar disorder in puberty. Methods 100 patients with manic episode of bipolar disorder in puberty were chosen and randomly divided into two groups according to the digital table. Group A ( 50 children ) was given magnesium valproate,and group B (50 children) was given quetiapine on the basis of lithium carbonate. The clinical efficacy,the BRMS score,PANSS score and WCST score before and after treatment and the incidence of adverse effects of the two groups were compared. Results There was no significant difference in clinical efficacy between the two groups (94. 00% vs. 90. 00%),(χ2 =1. 31,P>0. 05). After treatment for 2 weeks,the BRMS score,PANSS score and WCST score of group B were significantly better than those of group A and before treatment(t=2. 45,3. 16;2. 71,3. 26,2. 79, 3. 36,all P<0. 05). 6 weeksafter treatment,there were no significant differences in the BRMS score,PANSS score and WCST score between the two groups(t=1. 20,1. 08,1. 19,all P<0. 05). There was no significant difference in the incidence rate of adverse effects between the two groups(χ2 =1. 49,P>0. 05). Conclusion Two kinds of bigeminy drug therapy in the treatment of patients with manic episode of bipolar disorder in puberty possess the clinical effects and safety,and quetiapine combined with lithium can help to shorten the onset time and higher the compliance degree.