阿立哌唑与联合碳酸锂治疗双相障碍Ⅰ型躁狂发作的疗效  

Aripiprazole Alone or in Combination with Neurolithium for Mania in Bipolar Ⅰ Disorder

作　　者：祝敬溪[1] 瞿颖莹 许建君[1] 魏英[1] 顾冬云[1] 

机构地区：[1]常熟市第三人民医院精神科,江苏常熟215500

出　　处：《南昌大学学报（医学版）》2014年第10期37-40,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的比较阿立哌唑与联合碳酸锂治疗双相Ⅰ型躁狂发作患者的疗效和安全性。方法将89例双相Ⅰ型躁狂发作患者按随机数字表法分为3组。阿立哌唑组28例,给予阿立哌唑起始剂量10mg·d-1,最大剂量30mg·d-1,平均剂量(28.5±4.50)mg·d-1;碳酸锂组31例,碳酸锂起始剂量0.5g·d-1,最大剂量1.5g·d-1,平均剂量(1.18±0.21)g·d-1;阿立哌唑联合碳酸锂组30例,给予阿立哌唑起始剂量、最大剂量及平均剂量同阿立哌唑组,碳酸锂起始剂量、最大剂量及平均剂量为同碳酸锂组。3组均6周为1个疗程。于治疗前和治疗第1、2、4、6周末分别采用躁狂状态评定量表(BRMS)、临床疗效总评量表(CGI)及副反应量表(TESS)评定3组患者的疗效及不良反应。于治疗前及治疗6周末各检测1次血、尿常规,肝、肾功能,血糖、血锂浓度、血脂及脑电图等,以评价其安全性。结果阿立哌唑组、碳酸锂组、阿立哌唑联合碳酸锂组治疗后各时间段(1、2、4及6周末)的BRMS、CGI评分均明显低于治疗前(均P<0.01);阿立哌唑联合碳酸锂组治疗2、4及6周末的BRMS、CGI评分均低于阿立哌唑组和碳酸锂组(均P<0.05)。阿立哌唑组总有效率为75.0%,碳酸锂组总有效率为77.4%,阿立哌唑联合碳酸锂组总有效率为90.0%。阿立哌唑联合碳酸锂组总有效率均明显高于阿立哌唑组和碳酸锂组(均P<0.05)。3组均未出现严重的不良事件。治疗前后3组血、尿常规,肝、肾功能,血糖、血脂及脑电图均无明显异常改变。结论阿立哌唑单药治疗双相障碍Ⅰ型躁狂发作患者是安全、有效的,但阿立哌唑联合碳酸锂治疗双相障碍Ⅰ型患者总有效率均优于阿立哌唑和碳酸锂单药治疗。Objective To compare the efficacy and safety of aripiprazole and aripiprazole com-bined with neurolithium in the treatment of mania in bipolar I disorder.Methods A total of 89 patients with mania in bipolar I disorder were randomly treated with aripiprazole（aripiprazole group,n = 28 ）,neurolithium （neurolithium group,n = 31 ）or their combination （combination group,n = 30）for 6 weeks.In aripiprazole group,the initial,maximum and average dosages of aripiprazole were 10,30 and（28.5±4.50）mg·d-1 ,respectively.In neurolithium group,the ini-tial,maximum and average dosages of neurolithium were 0.5,1.5 and（1.18±0.21）g·d-1 ,re-spectively.In combination group,the initial,maximum and average dosages of aripiprazole were the same as aripiprazole group and the initial,maximum and average dosages of neurolithium were the same as neurolithium group.The curative efficacies were evaluated by Bech-Rafaelsen Mania Scale（BRMS）and Clinical Global Impression Scale（CGI）and adverse reactions by Treatment E-mergent Symptom Scale（TESS）before and after treatment for 1,2,4 and 6 weeks.Routine blood and urine parameters,hepatic and renal function,blood glucose,blood lithium,blood lipids and e-lectroencephalogram were determined before and after treatment for 6 weeks to assess the safety of treatment.Results After treatment,BRMS and CGI scores significantly decreased in all the three groups（P 〈0.01）.Compared with aripiprazole group or neurolithium group,BRMS and CGI scores significantly decreased in combination group after treatment for 2,4 and 6 weeks（P 〈0.05）.Moreover,the total effective rate in combination group（90.0%）was significantly higher than that in aripiprazole group（75.0%）or neurolithium group（77.4%）（P 〈0.05）.No serious adverse events occurred in all patients.In addition,no abnormal changes in routine blood and urine parameters,hepatic and renal function,blood glucose,blood lipids and electroencephalogram were found before and after treatment.Conclusion The treatme

关 键 词：双相障碍Ⅰ型 阿立哌唑 碳酸锂 联合治疗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]