丙戊酸钠针剂与片剂快速改善双相情感障碍躁狂发作的疗效比较

Therapeutic effect comparison between sodium valproate injection and tablet on rapidly improve manicepisode of bipolar disorder

目的对比喹硫平合并丙戊酸钠针剂与合并丙戊酸钠片剂快速改善双相情感障碍躁狂发作的疗效及副作用。方法采用编号随机法将符合入组条件的114名患者分为治疗组和对照组,两组均给予口服喹硫平治疗,治疗组予静脉滴注丙戊酸钠针剂治疗,对照组予口服丙戊酸钠片剂治疗,在治疗前、24h、第3d、第7d进行贝克-拉范森躁狂量表(Bech-Rafaelsen Mania Rating Scale,BRMS)评分,在治疗第7d使用副反应量表(Treatment Emergent Symptom Scale,TESS)评估不良反应。结果治疗后24h治疗组与对照组BRMS评分结果无差异,3d、7d治疗组改善情况优于对照组,差异有统计学意义(P<0.05),治疗7d后治疗组总有效率63.64%;对照组总有效率39.53%,差异有统计学意义(χ^(2)=5.41,P<0.05),TESS评估提示治疗组药物副反应概率更低,差异有统计学意义(χ^(2)=4.76,P<0.05)。结论喹硫平合并丙戊酸钠针剂比合并丙戊酸钠片剂控制躁狂发作更有效,且药物不良反应出现的概率更低。

Objective To compare the efficacy and side effects of quetiapine combined with sodium valproate injection and sodium valproate tablets in the treatment of manic episode of bipolar disorder.Methods 114 patients who met the entry conditions were randomly divided into treatment group and control group.Both groups were treated with oral quetiapine,the treatment group was treated with intravenous injection of sodium valproate,and the control group was treated with oral sodium valproate tablets.Bech-Rafaelsen Mania Rating Scale(BRMS)scores were scored before treatment,24 hours later,on the 3 day and the 7 day respectively,and Treatment Emergent Symptom Scale(TESS)was used to evaluate adverse reactions on the 7 day of treatment.Results There was no difference in BRMS score be-tween the treatment group and the control group 24 hours after treatment.The improvement of the treatment group was better than that of the control group on days 3 and 7,and the difference was statistically significant(P<0.05).The to-tal effective rate of the treatment group was 63.64%after 7 days of treatment.The total effective rate of the control group was 39.53%,and the difference was statistically significant(χ^(2)=5.41,P<0.05),TESS showed that the prob-ability of drug side effects in the treatment group was lower,and the difference was statistically significant(χ^(2)=4.76,P<0.05)。Conclusion Quetiapine combined with sodium valproate injection is more effective than sodium valproate tablets in controlling manic symptoms,and the probability of adverse drug reactions is lower.