喹硫平联合氯硝西泮治疗老年躁狂症的临床研究及对血清NE、5-HT、DA水平的影响  

Clinical study of quetipine combined with clonazepam in treatment of senile mania and its effect on serum levels of NE, 5-HT and DA

作　　者：甄晓红 邢字航 张晋兰 綦航 ZHEN Xiaohong;XING Zihang;ZHANG Jinlan;QI Hang(No.6 Department of Psychiatry,No.8 Hospital of Shijiazhuang,Shijiazhuang 050081,China)

机构地区：[1]石家庄市第八医院精神六科,河北石家庄050081

出　　处：《药物评价研究》2021年第2期385-389,共5页Drug Evaluation Research

摘　　要：目的探讨喹硫平联合氯硝西泮治疗老年躁狂症的临床疗效及其对血清去甲肾上腺素(NE)、五羟色胺(5-HT)、多巴胺(DA)水平的影响。方法选取2018年1月—2019年4月石家庄市第八医院老年躁狂症患者117例作为研究对象,根据治疗方案不同将患者分为对照1组、对照2组、观察组,每组各39例。对照1组口服富马酸喹硫平片,起始剂量为25 mg/次,2次/d,每隔1~3 d增加25 mg,最大剂量300~600 mg/d,分2~3次服用。对照2组口服氯硝西泮片,1 mg/d。观察组采用富马酸喹硫平片联合氯硝西泮片治疗,用法用量同对照1组、对照2组。3组均持续治疗8周。观察3组患者的临床疗效,同时比较3组的贝克-拉范森躁狂量表(BRMS)评分、阳性与阴性症状量表(PANSS)评分、及NE、5-HT、DA、白细胞介素(IL)-2、IL-1β、肿瘤坏死因子(TNF)-α的水平。结果治疗后,观察组总有效率为94.87%,显著高于对照1组的76.92%和对照2组的74.36%(P<0.05)。治疗2、4、6、8周后,3组BRMS评分和PANSS评分均显著降低(P<0.05);且观察组BRMS评分和PANSS评分显著低于同期对照1组、对照2组(P<0.05)。治疗8周后,3组血清5-HT、NE、DA、IL-2、IL-1β和TNF-α水平均显著降低(P<0.05);且观察组血清5-HT、NE、DA、IL-2、IL-1β和TNF-α水平较同期对照1组、对照2组显著降低(P<0.05)。结论喹硫平联合氯硝西泮治疗老年躁狂症患者的疗效显著,在提高神经递质因子水平、抑制炎性反应方面具有显著优势,可进一步缓解患者躁狂程度,减轻临床症状,且具有一定安全性,值得临床推广。Objective To explore the effect of quetipine combined with clonazepam on senile patients with mania, and its effect on serum levels of NE, 5-HT, and DA. Methods A total of 117 elderly patients with mania in the No.8 Hospital of Shijiazhuang from January 2018 to April 2019 were selected as the research subjects. According to different treatment regimens, the patients were divided into control group 1, control group 2 and observation group, with 39 cases in each group. Patients in the control group 1 were po administered with Quetiapine Fumarate Tablets, the initial dose was 25 mg/time, twice daily, 25 mg was added every 1 to 3 days, and the maximum dose was 300 to 600 mg/d, divided into 2—3 times. Patients in the control group 2 were po administered with Clonazepam Tablets, 1 mg/d. Patients in the observation group was treated with Quetiapine Fumarate Tablets and Clonazepam Tablets, and the usage and dosage were the same as control group 1 and control group 2. All three groups were treated for 8 weeks.The clinical efficacy of three groups was observed, and the levels of NE, 5-HT, DA, IL-2, IL-1β and TNF-α were compared among three groups. Results After treatment, the total effective rate of observation group was 94.87%, which was significantly higher than that of control group 1(76.92%) and control group 2(74.36%)(P < 0.05). After 2, 4, 6 and 8 weeks of treatment, the BRMS score and PANSS score in 3 groups were significantly decreased(P < 0.05), and BRMS score and PANSS score of observation group were significantly lower than those of control group 1 and control group 2 at the same period(P < 0.05). After 8 weeks of treatment, the serum levels of 5-HT, NE, DA, IL-2, IL-1β and TNF-α in three groups were significantly decreased(P < 0.05), and the levels of5-HT, NE, DA, IL-2, IL-1β and TNF-α in observation group were significantly decreased compared with control group 1 and control group 2 at the same period(P < 0.05). Conclusion Quetipine combined with clonazepam has significant efficacy in treatment of elde

关 键 词：喹硫平 氯硝西泮 躁狂症 去甲肾上腺素 五羟色胺 多巴胺 白细胞介素-2 白细胞介素-1β 肿瘤坏死因子 

分 类 号：R971[医药卫生—药品]