无抽搐电休克治疗用于治疗躁狂症患者疗效及安全性研究  

The comparison study of treating patients with mania by means of modified electric convulsive therapy and lithium carbonate combined quetiapine

作　　者：田常青[1] 

机构地区：[1]内蒙古精神卫生中心,内蒙古呼和浩特010010

出　　处：《疾病监测与控制》2014年第2期63-65,共3页Journal of Diseases Monitor and Control

基　　金：内蒙古卫生厅医疗卫生科研计划项目(2009040)

摘　　要：目的探讨无抽搐电休克治疗(MECT)对首发躁狂症患者治疗的疗效及安全性。方法将92例首发躁狂症患者随机分为两组,分为单用碳酸锂并喹硫平(下称对照组)组和碳酸锂并喹硫平与电休克治疗联合应用组(下称联用组),观察时间为8wk。于基线及治疗1、2、4、5、6、8周末,采用Bech-Rafaelsen躁狂量表(BRMS)、简明精神病评定量表(BPRS)、临床总体量表(CGI-SI)评定疾病严重程度和疗效,采用治疗中需处理的不良反应症状量表(TESS)和心电图、脑电图的改变评价治疗的安全性。最终纳入分析联用组和对照组各41例。结果联用组自治疗第2周末、对照组自治疗第5周末,BRMS躁狂量表、BPRS、CGI-SI因子分和总分均显著下降,与基线的差异具有统计学意义(P<0.05或P<0.01);自治疗第6周末始两组患者的BRMS躁狂量表、BPRS、CGI-SI全部12种因子分相比无统计学差异。8周观察中未发现二者对心电图没有明显影响,对脑电图有轻微影响,但均为轻度异常脑电图。结论无抽搐电休克治疗对首发躁狂的治疗有良好的疗效,而且起效迅速,安全性较好,对记忆功能的影响,随着治疗的结束及益智药物的用运逐渐恢复。Objective To investigate therapeutic efficacy and safety of MECT on first-episode mania patients. Methods We randomly divided 92 first-episode mania patients into Lithium carbonate and quetiapine and electric shock therapy group （combined treated group） and Single use of lithium carbonate combined with quetiapine group （contrasted group）, then observing 8 weeks. To aSSess the severity of the disease and the therapeutic efficacy with BRMS, BPRS, CGI-SI, assess therapeutic safety with TESS and ECG, EEG changes at baseline andlth, 2th, 4th, 5th, 6th, 8th weekend. Ultimately we brought 41 patients in each group respectively. Results BRMS, BPRS, CGI-SI score and total score have significantly decreased since the second weekend in combined treated group and the 5th weekend in contrasted group, and there are statistically significant difference with baseline （P〈0.05 or P〈0.01）. There are no significant differences in 12 kinds of factor score ofBRMS, BPRS, CGI-SI between the two groups since 6th weekend. There are no significantly effect on ECG and EEG in the two groups in 8 weeks. Conclusion MECT not only have a good treatment effect on first-episode mania patients but also have rapid onset and better safety, memory function recovered gradually with the the end of treatment and the use of the nootropic drug.

关 键 词：无抽搐电休克治疗 碳酸锂 躁狂症 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R971.43[医药卫生—临床医学]