无抽搐电休克疗法联合喹硫平治疗双相情感障碍躁狂发作的疗效研究  

Efficacy of maintenance electroconvulsive therapy combined with quetiapine treatment for manic episode of bipolar disorder

作　　者：钟建炯 张利红[1] 郑瑶[1] 张盛杰[1] Zhong Jianjiong;Zhang Lihong;Zheng Yao;Zhang Shengjie(Department of Psychiatry,Kangci Hospital of Jiaxing,Jiaxing 314500,Zhejiang Province,China)

机构地区：[1]嘉兴市康慈医院精神科,嘉兴314500

出　　处：《中国基层医药》2022年第2期212-216,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨无抽搐电休克疗法(MECT)联合喹硫平治疗双相情感障碍躁狂发作的疗效。方法选取嘉兴市康慈医院2019年1月至2020年8月住院治疗的双相情感障碍躁狂发作患者103例,按照抽签法分为观察组46例、对照组57例。观察组给予MECT联合喹硫平治疗,对照组给予丙戊酸镁缓释片联合喹硫平治疗,均连续治疗4周。比较两组临床疗效、住院总费用、住院药费、药占比、不良反应以及治疗前后Bech-Rafaelsen躁狂量表(BRMS)评分、威斯康星卡片分类测验(WCST)评分的变化。结果治疗4周后,观察组总显效率为76.09%(35/46),显著高于对照组的56.14%(32/57),差异有统计学意义(χ^(2)=4.45,P<0.05)。观察组住院总费用、住院药费及药占比分别为(16074.52±1019.81)元、(1374.52±619.81)元、8.70%,对照组分别为(15618.14±1550.34)元、(1261.14±750.34)元、10.53%,差异均无统计学意义(t=1.71、0.82,χ^(2)=0.09,均P>0.05)。观察组治疗4周后BRMS评分为(7.36±3.04)分,对照组BRMS评分为(10.23±2.37)分,差异有统计学意义(t=5.38、P<0.001)。观察组WCST评分中错误应答数、持续错误数分数分别为(40.45±3.61)分、(9.56±1.39)分,明显低于对照组的(48.59±4.51)分、(12.08±1.25)分;WCST评分中持续应答数为(33.85±2.50)分,明显高于对照组的(29.71±2.14)分,差异均有统计学意义(t=10.17、9.56、8.90,均P<0.001)。观察组、对照组不良反应总发生率分别为21.74%、22.81%,差异无统计学意义(χ^(2)=0.01,P>0.05)。结论MECT联合喹硫平治疗双相情感障碍躁狂发作患者效果显著,值得临床应用。Objective To investigate the efficacy of maintenance electroconvulsive therapy(MECT)combined with quetiapine treatment for manic episodes of bipolar disorder.Methods A total of 103 patients with manic episodes of bipolar disorder received treatment in Kangci Hospital of Jiaxing from January 2019 to August 2020 and were included in this study.They were randomly divided into observation(n=46)and control groups(n=57).The observation group was given MECT combined with quetiapine treatment and the control group was treated with magnesium valproate sustained-release tablets combined with quetiapine.All patients received 4 weeks of treatment.Clinical efficacy,total hospital cost,drug cost during hospitalization,drug proportion,adverse reactions,and scores of the Bech-Rafaelsdn Mania Rating Scale and the Wisconsin Card Sorting Test pre-and post-treatment were compared between the two groups.Results After 4 weeks of treatment,total response rate was significantly higher in the observation group than in the control group[76.09%(35/46)vs.56.14%(32/57),χ^(2)=4.45,P<0.05].In the observation group,total hospital cost,drug cost during hospitalization,and drug proportion were(16074.52±1019.81)yuan,(1374.52±619.81)yuan,and 8.70%respectively,which were not significantly different from those in the control group[(15618.14±1550.34)yuan,(1261.14±750.34)yuan,10.53%,t=1.71,0.82,χ^(2)=0.09,all P>0.05].After 4 weeks of treatment,Bech-Rafaelsdn Mania Rating score was significantly lower in the observation group than in the control group[(7.36±3.04)points vs.(10.23±2.37)points,t=5.38,P<0.001].The number of wrong responses and the number of perseverative errors in the Wisconsin Card Sorting Test in the observation group were(40.45±3.61)counts and(9.56±1.39)counts,respectively,which were significantly lower than those in the control group[(48.59±4.51)counts,(12.08±1.25)counts,t=10.17,9.56,both P<0.001].The number of perseverative errors in the Wisconsin Card Sorting Test was significantly higher in the observation group than in t

关 键 词：双相情感障碍躁狂发作 无抽搐电休克疗法 丙戊酸镁缓释片 喹硫平片 Bech-Rafaelsen躁狂量表 威斯康星卡片分类测验 疗效 不良反应 

分 类 号：R749.4[医药卫生—神经病学与精神病学]