碳酸锂联合丙戊酸镁治疗躁狂发作对照研究

A control study of lithium carbonate combined with magnesium valproate in manic episode

目的探讨碳酸锂联合丙戊酸镁治疗躁狂发作的临床疗效与安全性。方法将80例躁狂发作患者随机分成两组各40例，两组均口服碳酸锂治疗，研究组联合丙戊酸镁治疗，观察6w。于治疗前及治疗第1w、2w、4w、6w末采用Beek-Rafaelsen躁狂量表及副反应量表评定临床疗效及不良反应。结果治疗6w末，研究组显效率显著高于对照组（P〈0．05），总有效率无显著性差异（P〉0．05）；两组治疗后Beek-Rafaelsen躁狂量表评分均较治疗前有显著下降（P自〈0．01），研究组治疗1w、4w、6w末均较对照组下降显著（P〈0．05或0．01）；两组不良反应发生率及副反应量表总分均无显著性差异（P〉0．05），血锂浓度均维持在0．8mmol～1.1mmol·L^-1。结论碳酸锂联合丙戊酸镁治疗躁狂发作疗效优于单用碳酸锂，且起效快，血锂浓度均维持在安全治疗窗范围内，不增加药物不良反应，是治疗躁狂发作的有效方案。

Ohjeceive To explore the efficacy and safety of lithium carbonate plus magnesium valproate in the treatment of manic episode. Methods 80 patientswith manic episode were randomly divided into two troups of 40 ones each, both groups took orally lithium carbonate,and research group was added magnesium ralproate to for 6 weeks. Efficacies were assessed with the Beeh Rafaelsen Mania Rating Scale （BRMS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1^st, 2^nd, 4^th and 6^th week. Results At the end of the 6^th week,obvious effective rate was significantly higher in the research than in the control group（P〈 0.05）, there was no significant difference in total effective rate（P〉0. 05） ;after treatment, BRMS scores of both groups lowered more significantly compared with pretreatment（both P〈0.01）,so did in the research than in the control group at the end of the 1^st ,4^th and 6^th week（P〈0.05 or 0. 01） ; there were no significant differences in incidences of adverse reactions and total scores of the TESS（P〉0.05） ,blood lithium concen trations maintained 0.8 mmol-1. 1 mmol/L. Conclusion Lithium earbonaste combined with magnesium valproate has an advantage over single lithium carbonade, takes effect quickly, blood lithium concentrations maintained within safe therapeutic window limit, doesn＇t increase drug adverse reactions and is an effective schedule treating manic episode.