喹硫平联合丙戊酸镁治疗双相情感障碍躁狂发作的临床疗效及对患者认知功能的影响

Clinical efficacy of quetiapine combined with magnesium valproate in the treatment of manic episodes of bipolar disorder and its effect on cognitive function

目的探讨喹硫平联合丙戊酸镁治疗双相情感障碍(BPD)躁狂发作的临床疗效及对患者认知功能的影响。方法选取2021年7月至2022年4月本院收治的78例BPD碍躁狂发作患者作为研究对象,采用随机数字表法分为两组,每组39例。对照组采用丙戊酸镁治疗,观察组在对照组基础上联合喹硫平治疗,比较两组治疗前后贝克-拉范森躁狂量表(BRMS)评分、认知功能评分及临床疗效和不良反应发生情况。结果治疗后,两组BRMS评分均低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组持续性错误(RPE)、持续性应答数(RP)、错误应答数(RE)评分均低于治疗前,完成分类数(CC)、连续操作测验(CPT)及霍普金斯词语学习测验(HVLT-R)评分均高于治疗前,且观察组RPE、RP、RE评分均低于对照组,CC、CPT、HVLT-R评分均高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为97.44%,明显高于对照组的89.74%,差异有统计学意义(P<0.05)。观察组不良反应发生率为10.26%,明显低于对照组的23.08%,差异有统计学意义(P<0.05)。结论喹硫平联合丙戊酸镁治疗BPD躁狂发作效果显著,可有效改善患者认知功能,降低不良反应发生率,值得临床推广应用。

Objective To investigate the clinical efficacy of quetiapine combined with magnesium valproate in the treatment of manic episodes of bipolar disorder(BPD)and its effect on cognitive function.Methods 78 patients with manic episodes of BPD treated in our hospital from July 2021 to April 2022 were selected as the research subjects,and they were divided into two groups,with 39 cases in each group.The control group was treated with magnesium valproate,while the observation group was treated with quetiapine on the basis of the control group,the Bech-Rafaelsenmania rating scale(BRMS)score,cognitive function score before and after treatment,and clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the BRMS score of the two groups was lower than before treatment,and the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of perseverative responses errors(RPE),perseverative responses(RP)and responses errors(RE)in the two groups were lower than those before treatment,the scores of categories completed(CC),continuous performance test(CPT)and Hopkins verbal learning testrevision(HVLT-R)were higher than those before treatment,and the scores of RPE,RP,RE in the observation group were lower than those in the control group,the scores of CC,CPT and HVLT-R in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was 97.44%,which was significantly higher than 89.74%of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 10.26%,which was significantly lower than 23.08%in the control group,and the difference was statistically significant(P<0.05).Conclusion Quetiapine combined with magnesium valproate in the treatment of manic episodes of BPD has significant effect,which can effectively improve the cognitive function of patients and reduce the incidence of adverse reactions,which is is worthy of clinical promotion and application.