丙戊酸钠与无抽搐电休克治疗中老年双相情感障碍躁狂发作的疗效对比

Comparison of the curative effect of sodium valproate and modified electroconvulsive therapy for manic episode in middle-aged and senior patients with bipolar disorder

目的对比丙戊酸钠注射液与无抽搐电休克治疗中老年双相情感障碍躁狂发作的疗效。方法选择我院收治的86例中老年双相情感障碍躁狂发作患者,采用随机数表法将86例患者分为对照组43例和观察组43例,2组均予以常规药物治疗,对照组在常规治疗基础上进行无抽搐电休克治疗,观察组予以丙戊酸钠注射液治疗,治疗2周后使用杨式躁狂评定量表(YMRS)评价症状改善情况,使用连线(TMT)测验与威斯康星卡片分类(WCTS)测验比较2组认知功能改善情况,对比2组预后情况。结果治疗后2组YMRS评分与治疗前相比均降低,治疗后1周2组YMRS评分无明显差异(P>0.05);治疗后2周观察组YMRS评分显著低于对照组(P<0.05);治疗2周后观察组TMT与WCTS结果均优于对照组(P<0.05);观察组住院时间、住院费用、复发次数、约束时间和约束次数均低于对照组(P<0.05)。结论在中老年双相情感障碍躁狂发作的治疗中应用丙戊酸钠注射液的效果优于无抽搐电休克治疗,可更好改善患者的症状,缩短住院时间,节省治疗费用,值得临床推广。

Objective To compare the curative effect of sodium valproate injection and modified electroconvulsive therapy for manic episode in middle-aged and senior patients with bipolar disorder.Methods Totally 86 patients with bipolar disorder and manic episode in our hospital were divided into control group（n=43）and observation group（n=43）by random number table.The two groups were given conventional drug treatment.Besides this,the control group was given modified electroconvulsive therapy,while the observation group was given sodium valproate injection.Before and after 2-week treatment the two groups were tested by Yang-style Mania Rating Scale（YMRS）to assess their manic episode,and by Trail Making Test（TMT）and Wisconsin Card Sorting Test（WCST）to evaluate their cognitive function.Their prognosis were also compared.Results After treatment the YMRS scores of both groups were lower than those before treatment.After 1-week treatment the YMRS scores showed no significant difference in both groups（P0.05）.After 2-week treatment the YMRS score of the observation group was significantly lower than that of the control group（P0.05）.After 2-week treatment the results of TMT and WCST of the observation group were better than those of the control group（P0.05）.The observation group was also better than the control group on the aspects of length of hospital stay,hospital expenses,recurrence rate,constraints time and number of constraints,and there were significant differences between the two groups（P0.05）.Conclusion Sodium valproate injection has better curative effect than modified electroconvulsive therapy for manic episode in patients with bipolar disorder.It is worth clinical promotion.