无抽搐电休克治疗(MECT)合并药物与单纯药物治疗双相情感障碍躁狂相临床对照研究

Clinical Control Study on Drug or Drug Combined with MECT Therapying Bipdar Disorder Manic Phase

目的探讨无抽搐电休克治疗(MECT)合并药物与单纯药物治疗双相情感障碍躁狂相在起效时间、疗效及住院天数、治疗费用方面的差异。方法运用MECT合并药物治疗的30例双相情感障碍躁狂相患者的起效时间、住院天数、住院费用等指标与同期单纯药物治疗的32例患者进行比较并做回顾性分析。疗效评定依据简明精神病评定量表(BPRS)、贝克躁狂量表(BRMS)评分。结果 MECT合并药物治疗组和单纯药物治疗组治疗前BPRS和BRMS评分没有显著性差异(t=1.345,P>0.05和t=1.087,P>0.05);治疗后1、2、3周、出院前两组间有显著性差异(P<0.01);两组不同时点BPRS、BRMS评分与治疗前比较,差别均有显著性(P<0.01)。MECT合并药物治疗组平均住院31.6天,单纯药物治疗组平均住院50.1天,两组比较差异有显著性(U=6.0652,P<0.01);合并药物治疗组平均治疗费4169.90元,单纯药物治疗组平均治疗费5556.06元,两组比较差异有显著性(Z=4.790,P<0.01)。结论 MECT合并药物治疗组较单纯药物组治疗双相情感障碍躁狂相患者疗效好,起效快,减少了住院天数和住院费用。

Objective To compare the differences in the initial action time,the effect hospital treutment duys and the treatment expense on bipolar disorder between modified eleetroconvulsive therapy ctmlined with drug medication and drug therapy. Methods A total of 30 bipolar disorder patients treated with drug combined with MECT and 32 patients without MECT were involved. The initial action time, hospital treatment days and hospital expense were compared between two groups, review analysis was conducted. The effect was assessed according to the scores of the Brief Psychiatric Rating Scale （BPRS） and Beeh-Rafaelsen Mainia Rating Scale （BRMS）. Results By MECT with medication therapy and medication therapy, the scores of BPRS and BRMS had no difference before treatment （t= 1. 345, P〉0. 05 ;t= 1. 087 ,P〉0.05）, but significant differences were found after 1.2.3 weeks of treatment and before leaving hospital （P〈 0. 01）;significant differences were found of the two groups＇ scores of BPRS and BRMS at different times compared with those before treatment （P〈0.01）. The average hospital days of the MECT combined with medication group were 31.6 days,and those of the medication group were 50.1 days,the difference was significant （u = 6. 0652,P〈 0.01）. The averge treatment expense of the MECT with medication group was 4169.90 yuan,and that of the medication group was 5556.06 yuan,the difference was significant（z=4. 790,P〈0. 01）. Conclusion MECT with medication therapy is a effective fast, safe and economical method in treatment of bipolar disorder.