丙戊酸钠缓释片与碳酸锂治疗双相障碍Ⅰ型躁狂发作的疗效及安全性对比

Efficacy and Safety Contrast of Sodium Valproate Sustained Release Tablets and Lithium Carbonate in Treatment of the Patients with Manic Episode of TypeⅠ Bipolar Disorder

目的探讨丙戊酸钠缓释片与碳酸锂治疗双相障碍Ⅰ型躁狂发作的疗效及安全性。方法选择2012年8月至2013年8月在上海市精神卫生中心分部治疗的双相障碍Ⅰ型躁狂发作患者86例,按随机数字表法将其分为丙戊酸钠组和碳酸锂组,每组各43例,碳酸锂组给予碳酸锂治疗,丙戊酸钠组给予丙戊酸钠缓释片治疗。观察两组的治疗效果及不良反应情况。结果丙戊酸钠组的总有效率为83.72%,碳酸锂组为86.05%,差异无有统计学意义(P>0.05)。两组患者治疗前、治疗后1周、治疗后2周、治疗后4周躁狂量表评分比较,差异无统计学意义(P>0.05)。丙戊酸钠组治疗期间总不良反应发生率较碳酸锂组显著降低(32.56%vs 88.37%),差异有统计学意义(P<0.05)。结论采用丙戊酸钠缓释片治疗双相障碍Ⅰ型躁狂发作疗效与服用碳酸锂治疗相当,服药期间不良反应显著减少,值得在临床上大力推广使用。

Objective To explore the efficacy and safety of valproate zyban and lithium carbonate in the treatment of type I bipolar manic. Methods During Aug. 2012 and Aug. 2013 in Division of Shanghai Mental Health Center, 86 cases of type I bipolar manic patients were included in the study, and were divided into valproate zyban group and lithium carbonate group according to random-number table method ,43 cases in each group. The therapeutic effect and adverse reactions of the two groups were observed. Results The total efficiency of valproate zyban group was 83.72%, of lithium carbonate group was 86.05%, the difference was not statistically significance（ P 〉 0.05 ）. Before and 1 week after treatment ,2 weeks after treatment ,4 weeks after treatment the BRMS rating scaleof the two groups had no statistically significant difference（ P 〉 0.05 ）. The incidence of adverse reactions of valproate zyban group was 32.56% ,which was significantly lower than that of lithium carbonate group （88.37%）, and there was statistically significant difference between the two groups （ P 〈 0.05 ）. Conclusion Efficacy of valproate zyban treatment of manic episode of type I bipolar disorder is similar to lithium carbonate treatment, while the adverse reactions during medication is significantly reduced, therefore it should be vigorously promoted in clinical.