丙戊酸钠静脉滴注治疗双相障碍混合发作急性期的临床观察

Clinical observation of sodium valproate intravenous drip in the treatment of acute bipolar disorder mixed episode

目的:观察丙戊酸钠静脉滴注治疗双相混合发作急性期的疗效及安全性。方法:急性期双相障碍混合发作患者62例,随机分成丙戊酸钠注射组(32例)与口服组(30例),并给予相应的治疗2周;两组均合并喹硫平治疗。分别于治疗前、治疗第1周末、第2周末使用Young氏躁狂量表、汉密尔顿抑郁量表、危险性评估量表、药物不良反应量表及自杀风险量表进行病情评估。结果:两组治疗后第1周末、第2周末,Young氏躁狂量表、危险性评估量表及自杀风险量表评分,与基线比较差异有显著性(P均<0.01),注射组较口服组降低更多,两组间差异有统计学意义(P<0.05或P<0.01);注射组冲动行为干预及艾司唑仑肌注治疗次数较口服组使用更少,两组间差异有统计学意义(P均<0.01);汉密尔顿抑郁量表及药物不良反应量表评定两组间差异无统计学意义(P>0.05)。结论:丙戊酸钠静脉滴注治疗双相障碍混合发作急性期具有较好的疗效及安全性。

Objective:To observe the efficacy and safety of sodium valproate injection in the treatment of acute bipolar mixed episode.Method:62 patients with bipolar disorder mixed episode according to the International Classification of Diseases,Tenth edition(ICD-10)criteria were randomized to sodium valproate injection group(32 cases)or oral group(30 cases),observed for 2 weeks.Both groups were combined with quetiapine.Young's Manic Rating Scale(YMRS),Hamilton's Depression Scale(HAMD),Risk Assessment Scale,Treatment Emergent Symptom Scale(TESS),and Nurses'Global Assessment of Suicide Risk(NGASR)were administered before treatment,1 week and 2 weeks after the treatment.Results:Compared to baseline,significantly statistical differences of the rating scores of YMRS,Risk Assessment Scale amd NGASR were observed after 1 week and 2 weeks treatment in both groups(P<0.01),and the reduction of rating scores of injection group was more stastically compared to oral group(P<0.05).There were statistically significant differences of the frequency of the use of both impulsive behavior intenvention and eatazolam injection between injection group and oral group,which indicated injection group resulted reduced frequency(P<0.01).No significant difference was observed between injection group and oral group in the rating scores of HAMD and TESS(P>0.05).Conclusion:Sodium valproate intravenous drip in the treatment of acute bipolar disorder mixed episode results in statistically and clinically significant efficacy and safety.