喹硫平与丙戊酸钠缓释片在双相情感障碍躁狂发作治疗中的疗效比较

Comparison of efficacy of quetiapine and sodium valproate sustained-release tablets in the treatment of bipolar disorder manic episode

目的 对比分析喹硫平与丙戊酸钠缓释片在双相情感障碍躁狂发作治疗中的临床疗效。方法 52例双相情感障碍躁狂发作患者,采用随机数字表法分为A组和B组,每组26例。A组患者采用喹硫平治疗, B组患者采用丙戊酸钠缓释片治疗。比较两组患者临床疗效及贝克-拉范森躁狂量表(BRMS)评分降低1/2时间、治疗前后炎症因子水平、不良反应发生情况。结果 A组患者总有效率为96.15%,与B组的92.31%比较差异无统计学意义(χ^2=0.354, P=0.552>0.05)。A组患者BRMS评分降低1/2时间为(2.32±0.57)周,短于B组的(3.87±0.67)周,差异具有统计学意义(t=8.985, P=0.000<0.05)。治疗前,两组患者白细胞介素-1(IL-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比较差异无统计学意义(P>0.05);治疗后,两组患者IL-1、TNF-α水平低于本组治疗前, IL-10水平高于本组治疗前,且A组患者IL-1、TNF-α水平低于B组, IL-10水平高于B组,差异具有统计学意义(P<0.05)。A组患者不良反应发生率为3.85%,低于B组的30.77%,差异具有统计学意义(χ^2=6.584, P=0.010<0.05)。结论 喹硫平与丙戊酸钠缓释片治疗双相情感障碍躁狂发作疗效相当,但喹硫平的起效时间更快,能够显著改善炎症因子水平,且不良反应更少,这对于控制病情发展具有更高的临床应用价值。

Objective To compare and analyze the clinical efficacy of quetiapine and sodium valproate sustained-release tablets in the treatment of bipolar disorder manic episode.Methods A total of 52 patients with bipolar disorder manic episode were divided into group A and group B,with 26 cases in each group.Group A was treated by quetiapine,and group B was treated by sodium valproate sustained-release tablets.Comparison was made on clinical efficacy,Bech-Rafaelsdn mania rating scale(BRMS)score reduced by 1/2 time,levels of inflammatory factors before and after treatment,and occurrence of adverse reactions between the two groups.Results The total effective rate of group A was 96.15%,which had no statistically significant difference compared with 92.31%of group B(χ^2=0.354,P=0.552>0.05).The BRMS score reduced by 1/2 time was(2.32±0.57)weeks,which was shorter than(3.87±0.67)weeks in group B,and the difference was statistically significant(t=8.985,P=0.000<0.05).Before treatment,there was no statistically significant difference in levels of interleukin-1(IL-1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the levels of IL-1 and TNF-αwas lower than those before treatment,and IL-10 levels was higher than those before treatment.The levels of IL-1 and TNF-αin group A was lower than those in group B,and IL-10 level was higher than that in group B.Their difference was statistically significant(P<0.05).The incidence of adverse reactions was 3.85%in group A,which was lower than 30.77%in group B,and the difference was statistically significant(χ^2=6.584,P=0.010<0.05).Conclusion Quetiapine and sodium valproate sustainedrelease tablets shows equal efficacy in the treatment of bipolar disorder manic episode,but quetiapine has faster onset time,and can significantly improve the level of inflammatory factors with fewer adverse reactions,which has a higher clinical application value for the control of disease development.