双情感稳定剂快速缓解躁狂症状的对照研究

A comparative study of double mood stabilizers in treating manic symptoms

目的探讨双情感稳定剂快速治疗躁狂症的临床效果和不良反应。方法对88例患者分别应用双情感稳定剂(丙戊酸钠和碳酸锂联合应用的联合组)与单用碳酸锂组进行对照治疗;采用Bech-Rafaelsen躁狂量表(BRMS)及治疗时副反应量表(TESS)等评定。结果联合组与治疗前相比较,在第1周BRMS评分总分及动作、言语、意念飘忽、敌意/破坏、情绪、自我评价和睡眠等因子分明显下降(P<0.01～0.05),与碳酸锂组比较有显著性差异(P<0.01～0.05);在第2周BRMS评分语言/喧闹、接触、性兴趣和工作等因子分也明显下降(P<0.01),动作、言语、意念飘忽、语言/喧闹、敌意/破坏、情绪和睡眠等因子分与碳酸锂组比较有显著性差异(P<0.01～0.05)。与治疗前比较,碳酸锂组在第2周BRMS评分总分及言语、意念飘忽等因子分明显下降(P<0.05),在第4周BRMS评分动作、语言/喧闹、敌意/破坏、情绪、自我评价、接触、睡眠、性兴趣和工作等因子分明显下降(P<0.01～0.05)。在第4周两组BRMS评分情绪和接触因子之间仍有显著性差异(P<0.01～0.05)。两组药物不良反应发生率之间比较无显著性差异(P>0.05)。结论双情感稳定剂能够快速缓解躁狂症状,且有较好的安全性。

Objective To explore the clinical effects and adverse reactions of double mood stabilizers in treating maniac symptoms.Methods 88 cases were random divided into two groups： study group was treated with lithium carbonate combined with sodium valproate;controlled group was administrated using single lithium carbonate. All the patients were evaluated with Bech-Rafaelsen Mania Rating SCale（BRMS） and Treatment Emergent Symptom Scale （TESS）.Result Compared with the scores before treatment, the total scores of BRMS as well as movement,verbal,thought float,hostile,emotion,self-evaluated and sleep items decreased significantly in study group at first week and the difference also existed between the two groups. At combined treatment week,the scores concerning verbal, noise, contact, sexual interest and work decreased distinctly as the difference was significant compared with controlled group about the factor scores of movement, thought float, verbal, emotion and sleep. Compared with the scores before treatment, the total scores and the factor scores involved verbal, thought float at the second week decreased＂ markedly while the score of BRMS concerning movement, verbal, hostile, emotion, self-respect, contact, sleep, sexual interest and work at the fourth week.The score of BRMS about emotion and contact presented distinctly difference at the forth week as the rate of adverse reactions had no difference between the two group.Conclusion Double mood stabilizers can promptly alleviate the manic symptoms and have higher safety.