碳酸锂联合氟西汀治疗双相情感障碍的疗效  

Therapeutic Effectiveness of Lithium Carbonate Combined with Fluoxetine in the Treatment of Bipolar Affective Disorder

作　　者：朱培俊 王苑华[2] 朱培林[3] 张静 

机构地区：[1]浙江省丽水市第二医院精神科,323000 [2]温州医学院附属第五医院神经内科,323000 [3]浙江省丽水市人民医院内科,323000

出　　处：《医药导报》2005年第10期886-889,共4页Herald of Medicine

摘　　要：目的评价碳酸锂联用氟西汀治疗双相情感障碍的疗效和安全性。方法68例双相情感障碍患者随机分成治疗组和对照组各34例。治疗组给予碳酸锂1.0 g.d-1,氟西汀初始量20 mg.d-1,最大40 mg.d-1;对照组给予碳酸锂1.0 g.d-1,阿米替林初始量25 mg.d-1,1周后递增至150 mg.d-1,根据病情调整剂量,最大剂量250 mg.d-1。两组药物均为口服,疗程均为8周。采用汉密尔顿抑郁量表(HAMD)、临床总体评定量表(CG I)评定临床疗效,不良反应量表(TESS)评定不良反应。结果治疗组总有效率为90.9%,显效率为81.8%,对照组分别为80.8%和73.1%,两组比较差异无显著性(P>0.05)。治疗组不良反应少,依从性好,且转躁率较低。结论碳酸锂联用氟西汀治疗双相情感障碍有效、安全。Objective To assess the therapeutic effectiveness and safety rate of lithium carbonate combined with fluoxetine in the treatment of patients with bipolar affective disorder. Methods 68 patients with bipolar affective disorder were randomly divided into two equal groups, the treatment group and the control group. Patients of the treatment group were given each 1.0 g of lithium carbonate, q.d. combined with 20 mg （initial dose） to 40 mg（maximum dose） of fluoxetine, q. d.. Patients of the control group were given each 1.0 g of lithium carbonate, q.d. combined with amitriptyline beginning with an initial close of 25 mg q. d. , increasing to 150 mg q.d. 1 week later and reaching finally to a maximal dose of 250 mg q. d. if necessary, according to the patients＇condition. All of the 4 medicaments were administered orally, and the course of treatment in both group lasted 8 weeks. The clinical therapeutic effectiveness was assessed with the Hamilton Depressive Scale （HAMD） and Clinical Global Impression （CGI） ,while adverse reactions were appraised with the Treatment Emergent Symptom Scale（TESS）. Results The overall effective rates in patients of the treatment group and control group were 90.9% and 80.8%, respectively （P〉0.05）, and the rates of excellent therapeutic effect in patients of the treatment group and control group were 81.8% and 73.1% , respectively （P〉0.05）. However, in patients of the treatment group, adverse reactions were less common and there was a better drug compliance and lower rate of switching from depression to mania. Conclusion Lithium carbonate combined with fluoxetine was shown to be effective and safe in the treatment of patients with bipolar affective disorder.

关 键 词：碳酸锂 氟西汀 双相情感障碍 

分 类 号：R971.43[医药卫生—药品] R749.4[医药卫生—药学]