丙戊酸盐与碳酸锂分别联合氯氮平治疗双相情感障碍-躁狂发作的效果比较  

Comparison of effects of valproate and lithium carbonate in combined therapy with clozapine for bipolar disorder-mania

作　　者：周君亚 蔡婧 Zhou Junya;Cai Jing(Ward VI,Department of Psychiatry,the Fifth People’s Hospital of Kaifeng,Kaifeng 475000,China)

机构地区：[1]开封市第五人民医院精神科六病区,开封475000

出　　处：《中国实用医刊》2023年第19期85-88,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较丙戊酸盐联合氯氮平与碳酸锂联合氯氮平治疗双相情感障碍-躁狂发作的效果。方法抽取2020年1月至2022年12月于开封市第五人民医院接受治疗的双相情感障碍-躁狂发作患者84例,回顾性分析其病历资料。根据治疗方案不同分为对照组44例和观察组40例,对照组采用碳酸锂联合氯氮平治疗,观察组采用丙戊酸盐联合氯氮平治疗。比较两组患者的治疗效果、生活质量[简明健康调查表(SF-36)评分]及药物治疗安全性[副反应量表(TESS)评分]。结果观察组总有效率(87.50%,35/40)与对照组(84.09%,37/44)比较,差异未见统计学意义(P>0.05)。治疗前,两组SF-36评分比较,差异未见统计学意义(P>0.05);治疗后,两组SF-36评分均较治疗前提高,且观察组SF-36评分高于对照组(P<0.05)。治疗前,两组TESS评分比较,差异未见统计学意义(P>0.05);治疗4、8周时,两组TESS评分均较治疗前降低,且观察组TESS评分低于对照组(P<0.05)。结论丙戊酸盐联合氯氮平与碳酸锂联合氯氮平治疗双相情感障碍-躁狂发作的效果相当,均可改善患者的躁狂症状;但丙戊酸盐联合氯氮平治疗可以更好地改善患者的生活质量,且安全性更高。Objective To compare the efficacy of valproate combined with clozapine versus lithium carbonate combined with clozapine in the treatment of bipolar disorder-mania.Methods A total of 84 patients with bipolar disorder-mania who received treatment in the Fifth People’s Hospital of Kaifeng from January 2020 to December 2022 were selected,and their medical records were retrospectively analyzed.According to treatment plan,the selected patients were divided into control group(44 cases)and observation group(40 cases).The control group was treated with lithium carbonate combined with clozapine,while the observation group was treated with valproate combined with clozapine.The clinical treatment effect,quality of life assessed by the medical outcomes study item short form 36(SF-36)score,and drug treatment safety assessed by treatment emergent symptom scale(TESS)score were compared between the two groups.Results There was no significant difference in the total effective rate between the observation group(87.50%,35/40)and the control group(84.09%,37/44),P>0.05.Before treatment,there was no significant difference in SF-36 score between the two groups(P>0.05).After treatment,the SF-36 score of the two groups increased,compared with preoperative scores,moreover,the SF-36 score of the observation group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in TESS score between the two groups(P>0.05).At 4 and 8 weeks of treatment,the TESS score of both groups decreased,compared with preoperative scores(P<0.05);and the TESS score of the observation group was lower than that of the control group at 4 and 8 weeks of treatment(P<0.05).Conclusions The efficacy of valproate combined with clozapine has comparable therapeutic effect with lithium carbonate combined with clozapine in the treatment of bipolar disorder-mania.Both of them can improve the manic symptoms of patients.However,the combination of valproate and clozapine can better improve the quality of life of patients,with higher

关 键 词：双相情感障碍 躁狂发作 生活质量 丙戊酸盐 氯氮平 

分 类 号：R749.94[医药卫生—神经病学与精神病学]