奥氮平单药与联合碳酸锂治疗双相障碍躁狂发作患者的对照研究

Comparative study of mood stabilizer in treatment of manic episodes

目的：比较奥氮平单药与奥氮平联合碳酸锂治疗双相躁狂或混合发作患者的疗效与安全性。方法：60例双相障碍Ⅰ型躁狂发作或混合性发作患者随机分为单用药组29例和合用药组31例。分别给予奥氮平单药和奥氮平联合碳酸锂治疗。疗程4周。于基线时,治疗1,2,3和4周,分别采用临床总体印象量表-双相障碍版、Young躁狂量表（YMRS）、Montgomery-Asberg抑郁量表评定疗效,同时采用耐受性量表评价安全性。结果：单用药组和合用药组YMRS评分分别由治疗前的（30.10±5.86）分和（29.48±5.89）分降至治疗后的（11.21±6.54）分和（3.39±5.52）分（P均〈0.01）;两组比较,以合用药组下降更为显著（P〈0.05或P〈0.01）。单用药组和合用药组痊愈率分别为57.1%和90.3%（P〈0.05）。两组耐受性量表评分差异无统计学意义。结论：奥氮平无论单药或联合碳酸锂治疗躁狂发作均有确切疗效,以联合用药症状改善更为明显,不良反应相当。

Objective：To evaluate the efficacy and safety of olanzapine and olanzapine combined with lithium in the treatment of bipolar or mixed type mania. Method：60 patients were randomly received olanzapine（n=29） or olanzapine combined with lithium（n=31） for 4week.Patients were assessed every week by Young mania scale（YMRS） ,Montgomery-Asberg depression rating scale,and clinical global impression scale-bipolar disorde version to evaluate efficacy.At 1、2、3、4 weekends,the scales of tolerance were used to evaluate safety. Results：At the endpoint,compared to baseline,the improvement for YMRS were significant in both groups.The monotherapy group decreased from（30.10±5.86） to（11.21±6.54）（P0.01） .The concomitant therapy group decreased from（29.48±5.89） to（3.39±5.52）（P0.01） .The concomitant therapy group was more significant in these two group on the improvement for YMRS（P0.05 or P0.01） .The remission rate of the monotherapy group was 57.1%.The remission rate of the concomitant therapy group was 90.3%.The rating scales of tolerance were similar in both groups. Conclusion：Either used olanzapine singly or combined with lithium all had exact therapeutic effect in trial mania episode.Combined olanzapine and lithium was better in improving the mania symptoms,there was no obviously difference beween these two treatments .