喹硫平联合碳酸锂治疗双相情感障碍攻击行为效果比较

Comparison of the effect of quetiapine combined with lithium carbonate and with sodium valproate in the treatment of bipolar disorder patients with aggressive behaviors

目的比较喹硫平联合碳酸锂与联合丙戊酸钠治疗双相情感障碍患者攻击行为的效果。方法将93例符合CCMD-3诊断标准的双相情感障碍住院患者随机分为观察组(46例)与对照组(47例),观察组口服喹硫平联合碳酸锂治疗,对照组口服喹硫平联合丙戊酸钠治疗。采用"修改版外显攻击行为量表(MOAS)"评定治疗患者攻击行为的效果。结果两组患者治疗前"MOAS"评分差异无统计学意义(P>0.05),第2周末评分比较差异有统计学意义(P<0.001),第4及第8周末比较差异亦有统计学意义(P<0.001)。住院期间观察组发生攻击行为11起,对照组25起,两组比较差异有统计学意义(χ2=8.3996,P=0.0038)。药物副作用比较差异无统计学意义(χ2=0.5226,P=0.4697),临床治疗效果及住院时间比较差异无统计学意义(P>0.05)。结论喹硫平联合碳酸锂治疗双相情感障碍效果与喹硫平联合丙戊酸钠治疗效果相当,药物副作用差异不明显,但可显著降低住院患者的攻击性行为。

Objective To compare the effect of quetiapine combined with lithium carbonate and with sodium valproate in treating bipolar disorder patients with aggressive behaviors. Methods 93 inpatients with bipolar disorder, who met the CCMD-3 diagnostic criteria, were randomly divided into the observation group（46 cases） and the control group（47cases）.The observation group were treated with quetiapine combined with lithium carbonate by oral administration,while the control group were treated with quetiapine combined with sodium valproate by oral administration. Modified Overt Aggression Scales（MOAS） was used to evaluate the treating effect for attack behaviors.Results Before treatment, there was no significant difference in the ＂MOAS＂ scores between two groups（ P 〈0.05）,but at the end of the second week, the fourth week and the eighth week of the treatment, their difference was statistically significant（ P （0.001）.11 cases of aggressive behavior occurred in the observation group during hospitalization and 25 occurred in the control group,so the difference was statistically significant （χ2 =8.3996, P 0.0038）. No significant difference was found between groups in terms of side effect of drugs （χ2= 0.5226, P =0.4697） as well as the clinical curative effeect and hospitalization duration（ P 〉0.05）.Conclusion Quetiapine combined with lithium and quetiapine combined with sodium valproate have similar effect in treating patients with bipolar affective disorder. Both of them do not have obvious side effect of drugs,but they can significantly reduce aggressive behaviors of inpatients.