碳酸锂联合奥氮平治疗双相Ⅰ型障碍躁狂发作对照研究

A control study of lithium carbonate combined with olanzapine in the treatment of manic episode of bipolar I disorder

目的 探讨碳酸锂联合奥氮平治疗双相Ⅰ型障碍躁狂发作的临床疗效及安全性.方法 将80例双相Ⅰ型障碍躁狂发作患者按随机数字表法分为两组,每组40例.两组均予以碳酸锂治疗,研究组在此基础上联合奥氮平治疗,治疗前后采用杨氏躁狂量表、倍克·拉范森躁狂量表、临床总体印象疾病严重程度量表-双相障碍及副反应量表评定临床疗效及安全性. 结果 治疗前两组各量表总分比较差异无统计学意义（P〉0.05）;治疗后两组杨氏躁狂量表、倍克·拉范森躁狂量表、临床总体印象疾病严重程度量表-双相障碍总分均较治疗前显著降低（P〈0.01）,研究组显著低于对照组（P〈0.01）;治疗8周末研究组总有效率为90.0%,对照组为72.5%,研究组显著高于对照组（P〈0.05）.治疗后研究组副反应量表总分显著低于对照组（P〈0.01）. 结论 碳酸锂联合奥氮平治疗双相Ⅰ型障碍躁狂发作疗效显著,安全性高,优于单用碳酸锂治疗.

Objective To explore the efficacy and safety of lithium carbonate combined with olanzapine in the treatment of manic episode of bipolar I disorder.Methods Eighty patients with manic episode of bipolar I disorder were assigned to two groups of 40 ones each according to random number table.Both groups were treated with lithium carbonate, on this basis research group was plus olanzapine, and before and after treatment efficacies and adverse reactions were assessed with the Young Mania Rating Scale （YMRS）, Bech-Rafaelsen Mania Scale （BRMS）, Clinical Global Impressions of Severity Scale for Bipolar Disorder （CGI-S-BP） and Treatment Emergent Symptom Scale （TESS） respectively.Results There were no significant group differences in total scores of all scales before treatment （P〉0.05）;after treatment the YMRS, BRMS and CGI-S-BP scores of both groups lowered more significantly （P〈0.01） and those were significantly lower in research than in control group （P〈0.01）;at the end of the 8th week the total effective rate was respectively 90.0% in research and 72.5% in control group and the former significantly higher than the latter （P〈0.05）.After treatment the total score of the TESS was significantly lower in research than in control group （P〈0.05）.Conclusion Lithium carbonate combined with olanzapine has an evident effect and higher safety compared with single lithium carbonate in the treatment of manic episode of bipolar I disorder.