奎硫平联合丙戊酸钠治疗住院双相躁狂患者的有效性和安全性分析

Study on the efficacy and safety of application of QCG combined with sodium valproate in treatment of hospitalized patients with bipolar mania

目的研究双相躁狂患者应用奎硫平与丙戊酸钠联合治疗的临床效果。方法回顾性分析自2008年8月至2013年8月治疗的87例双相躁狂患者临床资料,依据治疗方式将其分为研究组(n=45)、对照组(n=42)。对照组单独应用喹硫平治疗,研究组应用奎硫平与丙戊酸钠联合治疗,两组均规律治疗2月。对两组治疗的临床效果、外显攻击行为量表(MOAS)、躁狂量表(BRMS)、阳性、阴性症状量表(PANSS)、执行能力量表(WCST)、言语记忆测评量表(HVLT-R)、持续操作、注意力测评量表(CPT)、不良反应量表(TESS)等情况进行对比分析。结果研究组痊愈率、有效率高于对照组,差异有显著性(P<0.01)。研究组治疗后各时点MOAS评分明显低于对照组,BRMS、PANSS评分均低于对照组,差异有显著性(P<0.05)。研究组治疗后WCST、HVLT-R、CPT均明显高于对照组,差异有显著性(P<0.05)。两组TESS评分比较,差异无显著性(P>0.05)。结论双相躁狂患者应用奎硫平与丙戊酸钠联合治疗,不仅能够降低患者发生攻击行为的可能性,控制患者阳性症状,同时能够提高患者执行力,改善患者言语、记忆力,并且能够提高患者持续操作能力和注意力,减少不良反应,安全有效,值得临床推广应用。

Objective To study the clinical efficacy of quetiapine and sodium valproate in treatment of patients with bipolar mania. Methods The clinical data of 87 patients with bipolar mania admitted in the department of this hospital during August 2008 to August 2013 were retrospectively analyzed,and all patients were divided into study group（n = 45）and control group（n = 42）on the basis of treatment. Patients in control group were treated with quetiapine and patients in study group were treated with quetiapine and sodium valproate combination therapy,all patients in these two groups were treated for 2 months,the efficacy of patients in these 2 groups had been evaluated by MOAS（overt aggression scale）,BRMS（quantitative mania scale）,PANSS（positive and negative symptom scale）,WCST（Executive Ability Scale）,HVLT - R（verbal memory assessment scale）,CPT（the continuous operation and attention scale）and TESS（adverse reactions scale）were compared and analyzed. Results The difference in rates of cure and efficiency in study group compared with those of control group was significant（ P ﹤ 0. 01）. The difference in MOAS scores of study group at each time point after treatment compared with those of control group was significant（ P ﹤ 0. 01）. The difference in BRMS and PANSS scores between these 2 groups was significant（ P ﹤ 0. 05）. The difference in WCST,HVLT - R and CPT be-tween these 2 groups after treatment was significant（ P ﹤ 0. 05）. TESS in study group in comparison with that of control group,the difference was not significant（ P ﹥ 0. 05）. Conclusion The application of quetiapine and sodium valproate in treatment of patients with bipolar mania can re-duce the possibility of occurrence of symptoms for aggression and can also raise the ability of execution and improve the capability of speech and memory in these patients,and it can improve the sustained operation and attention and reduce the adverse reactions in patients,hence it is safe and effective,thus it should be popularized.