丙戊酸镁治疗酒精所致精神障碍患者的效果及安全性分析

Efficacy and Safety Analysis of Magnesium Valproate in the Treatment of Alcohol-induced Mental Disorders

目的:探讨丙戊酸镁治疗酒精所致精神障碍患者的效果,并分析其用药安全性。方法:选取2020年10月-2021年12月赣州市第三人民医院精神科收治的200例酒精所致精神障碍患者,按照随机数字表法将其分为丙戊酸镁组(n=100,使用丙戊酸镁治疗)和碳酸锂组(n=100,使用碳酸锂治疗),均治疗8周。对比分析两组危险行为[修订版外显攻击行为量表(MOAS)]、阳性和阴性综合征量表(PANSS)及社会功能缺陷量表(SDSS)评分、血清营养因子[脑源性神经营养因子(BDNF)与神经生长因子(NGF)]水平、治疗效果[临床总体印象量表(CGI)]及副作用[药物不良反应量表(TESS)]。结果:治疗后,两组PANSS、SDSS、MOAS评分均低于治疗前,且丙戊酸镁组均低于碳酸锂组(P<0.05)。治疗后,两组BDNF、NGF水平均高于治疗前,且丙戊酸镁组均高于碳酸锂组(P<0.05)。治疗后,两组CGI量表中的严重程度(SI)评分均低于治疗前,且丙戊酸镁组SI、疗效总评(GI)评分均低于碳酸锂组(P<0.05)。丙戊酸镁组各不良反应发生率与碳酸锂组比较,差异均无统计学意义(P>0.05)。结论:丙戊酸镁对酒精所致精神障碍患者攻击性的改善效果对比碳酸锂更加显著,且不会带来明显副作用,安全性较佳。

Objective: To investigate the efficacy and safety of Magnesium Valproate in the treatment of alcohol-induced mental disorders. Method: A total of 200 patients with alcohol-induced mental disorders admitted to Department of Psychiatry, Ganzhou Third People’s Hospital from October 2020 to December 2021were selected, they were divided into Magnesium Valproate group(n=100, treated with Magnesium Valproate) and Lithium Carbonate group(n=100, treated with Lithium Carbonate) according to random number table method, and both groups were treated for 8 weeks. The risk behavior [modified overt aggression scale(MOAS)], positive and negative syndrome scale(PANSS) and the social disability screening schedule(SDSS) scores, serum nutrition factor [brain derived neurotrophic factor(BDNF) and nerve growth factor(NGF)] levels, therapeutic effect [clinical global impression scale(CGI)] and side effects(TESS) were analyzed. Result: After treatment, PANSS, SDSS and MOAS scores in both groups were lower than those before treatment, and those in the Magnesium Valproate group were lower than those in the Lithium Carbonate group(P<0.05). After treatment, the levels of BDNF and NGF in both groups were higher than those before treatment, those in the Magnesium Valproate group were higher than those in the Lithium Carbonate group(P<0.05). After treatment, the severity(SI) scores of the CGI scale in the both groups were lower than those before treatment, and the SI and global improvement(GI) scores in the Magnesium Valproate group were lower than those in the Lithium Carbonate group(P<0.05). There were no significant differences in the incidence of adverse reactions between Magnesium Valproate group and Lithium Carbonate group(P>0.05).Conclusion: Magnesium Valproate has a more significant improvement effect on aggression in patients with alcoholinduced mental disorders than Lithium Carbonate, and it does not bring significant side effects, with better safety.