丙戊酸钠缓释片联合利培酮治疗双相情感障碍躁狂发作的效果观察

Observation of the effect of sodium valproate sustained-release tablets combined with risperidone in the treatment of bipolar disorder manic episode

目的:探讨丙戊酸钠缓释片联合利培酮治疗双相情感障碍躁狂发作的效果。方法:纳入2017年5月-2019年2月江西省吉安市第三人民医院精神科收治的双相情感障碍躁狂发作患者62例,依据随机对照原则分为对照组和观察组,每组各31例。对照组给予丙戊酸钠缓释片单药治疗,起始剂量200 mg/次,2次/d;治疗7 d后增加剂量至800~1 000 mg/d,2次/d。观察组给予丙戊酸钠缓释片联合利培酮治疗,丙戊酸钠缓释片用法同对照组,利培酮起始剂量为1 mg/次,1次/d;治疗7 d后增加剂量至2~4 mg/d,2次/d。两组均治疗6周。观察躁狂症状评分(YMRS)、字母认知功能量表(TMTB)评分和数字认知功能量表(TMTA)变化情况及疗效。结果:观察组总有效率为96.77%,高于对照组的70.97%(P <0.05);观察组YMRS、TMTB评分和TMTA评分均较低,和干预前以及对照组对比差异有显著性(P <0.05)。结论:丙戊酸钠缓释片联合利培酮治疗双相情感障碍躁狂发作效果较好,可以缓解患者躁狂症状,改善认知功能,应用价值较高。

Objective:To investigate the effect of sodium valproate sustained release tablets combined with risperidone in the treatment of bipolar disorder manic episode.Methods:Sixty-two patients with bipolar disorder manic episode who were admitted to the Psychiatric Department of the Third People’s Hospital of Jian City,Jiangxi Province from May 2017 to February 2019 were included,and according to the principle of random control,divided into a control group and an observation group with 31 cases in each group.The control group was given monotherapy of sodium valproate sustained-release tablets,with an initial dose of 200 mg/time,twice/day;after 7 days of treatment,the dose was increased to 800~1000 mg/d,2 times/d.The observation group was given sodium valproate sustained-release tablets combined with risperidone,the usage of sodium valproate sustained-release tablets was the same as the control group,the initial dose of risperidone was 1 mg/time,once/day;after 7 days of treatment,the dose was increased to 2~4 mg/day,twice/day.The treatment was for six weeks.The changes and efficacy of the manic symptom score,alphabet cognitive function scale score and digital cognitive function scale were observed.Results:The total effective rate of the observation group was 96.77%,which was higher than that of the control group 70.97%(P<0.05);the manic symptom score,alphabet cognitive function scale score and digital cognitive function scale score of the observation group were lower than those of the pre intervention and the control group,and the differences were significant(P<0.05).Conclusion:Sodium valproate sustained-release tablets combined with risperidone is effective in the treatment of bipolar disorder manic episode,can relieve manic symptoms of patients,improve cognitive function,and has high application value.