齐拉西酮联合心境稳定剂治疗双相障碍Ⅰ型躁狂或混合发作的疗效分析  

Ziprasidone combined mood stabilizers in the treatment of bipolar disorder typeⅠacute manic or mixed episode of curative effect analysis

作　　者：万雅洁 刘莎[1,6] 曹德 吴建杰 田峰 王宇 王彦芳 徐勇[1,6] WAN Yajie;LIU Sha;CAO De(Department of Mental Health,the First Hospital of Shanxi Medical University/the First Clinical Medical College,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院/第一临床医学院精神卫生科,太原030001 [2]大同市第六人民医院 [3]山西省社会福利精神康宁医院 [4]山西医科大学第二医院 [5]长治市精神卫生中心 [6]精神障碍人工智能辅助诊疗山西省重点实验室

出　　处：《国际精神病学杂志》2021年第1期36-41,共6页Journal Of International Psychiatry

基　　金：国家重点研发计划(2016YFC1307004);国家自然科学基金(81971601,81701326);山西省科技成果转化引导专项(201904D131020);山西省卫健委科研课题(2018GW01);认知障碍多学科诊疗山西省科技创新团队(201705D131027);三晋学者支持计划;“136”兴医工程。

摘　　要：目的探讨齐拉西酮联合心境稳定剂治疗双相情感障碍Ⅰ型急性躁狂或混合发作的临床疗效及安全性。方法选取2017年11月~2018年6月期间住院治疗的154例双相情感障碍Ⅰ型急性躁狂或混合发作的住院患者作为研究对象,随机分成试验组与对照组,试验组给予齐拉西酮联合碳酸锂或丙戊酸钠治疗,对照组给予单一的碳酸锂或丙戊酸钠治疗。比较两组患者治疗前及治疗2、4、8周的杨氏躁狂量表(Young mania rating scale,YMRS)评分、临床疗效及用药安全性情况。结果YMRS分数的组别×时间的交互作用无统计学意义(F=0.947,P=0.392);治疗2周、4周、8周,试验组的YMRS减分率高于对照组(F=16.209,P=0.027);随着试验组治疗时间的增加,患者的YMRS减分率逐渐升高(F=245.385,P<0.001)。两组间有效率差异有统计学意义(91.67%vs 91.38%,χ^(2)=1.62,P<0.05)。两组间痊愈率差异具有统计学意义(81.25%vs 70.69%,χ^(2)=2.30,P<0.05)。试验组与对照组的各代谢指标均无临床意义,虽未发生严重的药物副作用,但两组间的药物副作用仍有差异(χ^(2)=4.839,P<0.05),试验组的副作用发生率低于对照组。结论较单一使用心境稳定剂而言,齐拉西酮合并碳酸锂或丙戊酸钠治疗双相情感障碍Ⅰ型急性躁狂或混合发作的临床疗效确切,且不良反应的发生率更低。Objective To study the ziprasidone combined mood stabilizer treatment of bipolar disorder typeⅠacute manic or mixed episode of clinical efficacy and safety.Methods In November 2017 to June 2018,154 cases hospitalized during the period of bipolar disorder typeⅠacute manic or mixed episode hospitalized patients as the research object,randomly divided into experimental group and control group,experimental group give ziprasidone combined carbonic acid lithium or valproate treatment,control group given single carbonic acid lithium or valproate treatment.The scores and clinical efficacy of young's mania scale(YMRS)before treatment and 2,4 and 8 weeks after treatment were compared between the two groups to observe the occurrence of adverse reactions.Results The group×time interaction of YMRS score was not statistically significant(F=0.947,P<0.392).After treatment for 2 weeks,4 weeks and 8 weeks,the score reduction rate of YMRS in the experimental group was higher than that in the control group(F=16.209,P=0.027).With the increase of treatment time in the experimental group,the score reduction rate of YMRS gradually increased(F=245.385,P<0.001).The difference in effective rate between the two groups was statistically significant(91.67%vs 91.38%,χ^(2)=1.62,P<0.05).The difference of recovery rate between the two groups was statistically significant(81.25%vs 70.69%,χ^(2)=2.30,P<0.05).Although the experimental group and the control group did not have serious drug side effects,there were differences in drug side effects between the two groups(χ^(2)=4.839,P<0.05),and the incidence of side effects in the experimental group was lower than that in the control group.Conclusion Compared with the single use of mood stabilizers,ziprasidone combined carbonic acid lithium or valproate in the treatment of bipolar disorder typeⅠacute manic or mixed episode of clinical curative effect,and lower the incidence of adverse reactions.

关 键 词：齐拉西酮 心境稳定剂 急性躁狂发作 混合发作 双相情感障碍Ⅰ型 

分 类 号：R749.053[医药卫生—神经病学与精神病学]