喹硫平联用碳酸锂治疗双相障碍抑郁相的对照研究

A control study of quetiapine combined with lithium in the treatment of bipolar depression

目的通过喹硫平和氟西汀分别联用碳酸锂对双相型障碍抑郁相的对照研究,评价喹硫平的8周效果及安全性。方法两组入组32例和31例,年龄(30.6±10.2)岁和(31.6±11.2)岁,完成8周治疗30例和28例,脱落率为6.3%和9.7%。两组碳酸锂剂量(1.1±0.3)g/d和(1.1±0.3)g/d,喹硫平、氟西汀剂量分别为(320.0±89.6)mg/d和(27.2±11.2)mg/d。结果两组8周有效率(减分率≥50%者)为70.0%和78.6%,经Ridit分析两组差异无统计学意义,P>0.05。治疗2、4、8周与治疗前HAMD总分及因子分经配对比较,两组下降差异有统计学意义,P<0.01。在同期因子减分比较中,喹硫平组的焦虑躯体化和迟缓因子分别在2、4、8周时低于氟西汀组,睡眠障碍因子却在4、8周时大于氟西汀组,差异有统计学意义,P<0.05～0.01。两组不良反应按SS集分析中,喹硫平组更多具有困倦嗜睡、体重增加;氟西汀组多反映在失眠多梦、口干、出汗;两组差异有统计学意义,P<0.05～0.01。结论两组在碳酸锂剂量相同的情况下,8周疗效相当,不良反应基本相似,但喹硫平组未见转躁患者。

Objective To explore the curative effect and safety of quetiapine combined with lithium in the treatment of bipolar depression.Methods There were 32 patients aged（30.6 ± 10.2） years in research group receiving quetiapine plus lithium,dose of（320.0 ± 89.6） mg / day and（1.1 ± 0.3） g / day.And 31 patients aged（31.6 ± 11.2） years in research group receiving fluxetine plus lithium,dose of（27.2 ± 11.2） mg / day and（1.1 ± 0.3） g / day.After 8 weeks of treatment,there were 30 cases and 28 cases remained,the loss rates were 6.3% and 9.7%.Results The efficiency（reduced rate ≥50%） of the two groups was 70.0% and 78.6%,there was no significant difference（p 0.05）.Compared with the HAMD total score and factor scores before treatment and at 2,4,8 weeks,there were both significant difference decreased（P0.01） in the two groups.Sub factor in the same period by comparison,the anxiety and retardation factors in quetiapine group were lower than in fluoxetine group at 2,4,8week.The sleep disturbance factor in quetiapine group was greater than in fluoxetine group at 4,8weeks.There was significant and very significant difference（P0.05~0.01）.According to the analysis of SS,there were more sleepy lethargy,weight gain in quetiapine group,and more insomnia,dry mouth,sweating in fluoxetine group,there were significant or very significant differences（P0.05~0.01） between the two groups.Conclusion In the case of the same dose of lithium,two groups were effective,with similar side effects,but there was no case induced to mania in quetiapine group.