丙戊酸镁缓释片联合奥氮平治疗脑血管病致精神障碍患者的疗效观察

Observation of effects of Magnesium valproate sustained-release tablets combined with Olanzapine in treatment of mental disorders due to cerebrovascular disease

目的:探讨丙戊酸镁缓释片联合奥氮平治疗脑血管疾病致精神障碍患者的疗效。方法:67例脑器质疾病致精神障碍患者进行为期6周的对照研究,随机分为研究组和对照组。研究组患者32例,给予丙戊酸镁缓释片合并奥氮平;对照组35例,给予单用奥氮平片治疗。在治疗前和治疗第2、4、6周末,使用阳性与阴性症状量表(PANSS)、临床疗效总评量表(CGI)评价两组患者的临床疗效;采用不良反应量表(TESS)评定两组患者的药物不良反应。结果:治疗后,两组患者的PANSS、CGI评分均较治疗前显著下降(P<0.05)。治疗6周末,研究组患者治疗的有效率78.1%,对照组为62.9%,差异具有统计学意义(P<0.05)。从治疗4周末起,研究组患者的PANSS症状总分、阳性症状分、CGI评分均较对照组下降(P<0.05)。两组患者的TESS评分差异无显著性(P>0.05)。结论:丙戊酸镁缓释片联合奥氮平治疗脑血管病致精神障碍患者优于单独使用奥氮平,尤其显著改善患者的阳性症状。

Objective To explore efficacy of Magnesium valproate sustained- re lea se tablets combined with Olanzapine in treat-ment of mental disorders caused by cerebrovascular disease. Methods ： 67 patients were randomized into study group （3 2 c a se s , trea-ted with Magnesium valproate sustained-release tablets combined with Olanzapine for 6 weeks） and control group （35cases, treated with Olanzapine for 6 weeks. Positive and negative syndrome scale （PANSS） and clinical global impression （ CGI） as well as treatment emergent symptoms scale （TESS） were used to evaluate the efficacy and side effects at baseline and at the end of 2nd, 4th, 6th week of the treatment. Results ： The scores of PANSS and CGI of both groups lowered more significantly after the treatment compared with pretreatment （P〈0. 05）. The total effective rates of study group and control group were 78. 1% and 62.9% , and the difference was statistically significant at the end of the sixth week of the treatment （ P〈0. 05）. The total score of PANSS, the score of positive symp-toms and the score of CGI of study group decreased significantly from the end of the fourth week than control group （ P〈0. 05）. The difference of the TESS total scores were not statistically significant between the two groups （ P〉0. 05）. Conclusions ： Magnesium val-proate sustained-release tablets combined with Olanzapine is more effective than single Olanzapine for mental disorders caused by cere-brovascular disease, and the positive symptoms are improved significantly.