碳酸锂合并当归承气汤治疗躁狂发作的临床对照研究  

Clinical study on lithium carbonate combined with Danggui Chengqi decoction in treatment of mania patients

作　　者：龙彬 朱丽萍[1] 张建明[1] 吴海苏[1] 卢卫红 茅永骏 岳英[3] 陆国平[3] 饶顺曾[4] 汪作为[5] 赵敏[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,201108 [2]上海市闵行区精神卫生中心 [3]上海市黄浦区精神卫生中心 [4]上海市徐汇区精神卫生中心 [5]上海市虹口区精神卫生中心

出　　处：《神经疾病与精神卫生》2014年第4期364-367,共4页Journal of Neuroscience and Mental Health

基　　金：基金项目：上海市科学技术委员会中药现代化专项基金（11DZ1972800）

摘　　要：目的 评价当归承气汤对躁狂发作的临床疗效和安全性。方法 应用随机、双盲、病例对照研究方法，将123例患者随机分成当归承气汤组41例、单用碳酸锂组42例和当归承气汤合并碳酸锂组40例，单药组联合应用另一种药物的安慰剂，疗程8周，在治疗前、治疗后2，4，8周末时，采用Young氏躁狂量表（YMRs）、治疗不良反应量表（TESS}及自拟中医症候量表等进行评定。结果 单用当归承气汤患者总疗效（46．34％）比单独使用碳酸锂（80．49％）或两药合用（86．84％）低，3组间比较差异有统计学意义（X^2=41．43，P〈0．01）。3组自拟中医症候量表评分比较，各组治疗后2，4，8周自拟中医症候量表总分与治疗前比较差异有统计学意义（P〈0．01）；3组之间两两比较，治疗2周后当归承气汤组与合用组、碳酸锂组与合用组比较差异有统计学意义（P〈0．01），治疗4周后当归承气汤组与合用纽差异有统计学意义（P〈0．05），3组在治疗后8周量表总分两两比较差异均有统计学意义（P〈0．05）；当归承气汤组不良反应发生率明显低于碳酸锂组与合用组（P〈0．01）。结论 当归承气汤合并碳酸锂治疗躁狂发作疗效好、安全性高、值得临床推广应用。Objective To observe the efficacy and safety of Danggui Chengqi Decoction in treat ment of mania patients. Methods Totals of 123 patients meeting the criteria of CCMD-3 for mania were randomly divided into three groups, the lithium carbonate group （n =42）, the Danggui-Chengqi decoction group （n =41） and the Danggui-Chengqi decoction combined with lithium carbonate group （the combined group, n =40）, mania patients were gaven Danggui-Chengqi decoction and lithium carbonate and placebo respectively, they were treated for 8 weeks. Clinical efficacy and the safety were evaluated with Young Mania Rating Scale （YRMS） and Traditional Chinese medicine symptom scale and Treatment Emergent Symptom Scale（TESS） separately. Results The therapeutic effect rate of Danggui Chengqi decoction group was 46.34% which was lower than lithium carbonate group（80.49%） and combined group （86.84% ）, and the difference was significant （X^2 = 41.43, P ~ 0.01）. At the end of 2th, 4th, 8th week after treatment, the total scores of Traditional Chinese medicine symptom scale were all showed significantly increased in each group compared with that before treatment （P 〈 0. 01） ; the comparations were conducted between any two groups, there were significant differences at the end of 2th week after treatment between the Danggui Chengqi decoction group or lithium carbonate group and combined group （P 〈0.0l）, there were significant differences at the end of 4th week after treatment between the Danggui Chengqi decoction group and combined group （P 〈 0.05）, there were significant differences at the end of 8th week after treatment between any two groups （P 〈 0.01）. Treatment emergent symptoms rate in Danggui Chengqi decoction group was lower than lithium carbonate group and combined group （P 〈 0.01）. Conclusions It is effective and safe to treat mania using Danggui-Chengqi decoction combined with lithium carbonate, which is worthy to populize and applicate in clinic.

关 键 词：碳酸锂 当归承气汤 躁狂发作 疗效 

分 类 号：R749.410.5[医药卫生—神经病学与精神病学]