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碳酸锂联合丙戊酸钠治疗双相情感障碍躁狂发作的效果和安全性分析 被引量:20

Efficacy and safety contrast of lithium carbonate combined with sodium valproate in treatment of patients with manic episodes of bipolar disorder
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摘要 目的 :探讨碳酸锂联合丙戊酸钠治疗双相情感障碍躁狂发作的疗效及安全性。方法 :将150例双相情感障碍躁狂发作患者随机分为对照组和观察组,每组75例,对照组单用碳酸锂治疗,观察组给予碳酸锂联合丙戊酸钠治疗,治疗4周。采用贝克‐拉范森躁狂量表评定躁狂状况,阳性与阴性症状量表评定精神症状,威斯康星片分类测验、言语记忆测验、持续操作测验评定认知功能,副反应量表评定不良反应。结果 :治疗后两组BRMS评分和PANSS评分较治疗前均下降,且观察组低于对照组;WCST评分、HVLT-R评分、CPT评分较治疗前均有所提高,且观察组明显高于对照组,对照组WCST评分、HVLT-R评分较治疗前,差异无统计学意义;对照组总有效率84%,观察组总有效率94.7%,明显高于对照组;对照组的不良反应发生率为76.0%,观察组为29.3%,明显低于对照组。结论 :采用碳酸锂联合丙戊酸钠治疗双相情感障碍躁狂发作,可显著提高临床疗效,安全性高,且能有效改善患者的认知功能,优于单用碳酸锂治疗,值得在临床中推广应用。 Objective To investigate the efficacy and safety of lithium carbonate combined with sodium valproate in the treatment of patients with manic episodes of bipolar disorder.Methods 150 patients with bipolar disorder who had manic episodic were randomly divided into control group and observation group,75 cases in each group.The control group was treated with lithium carbonate alone,the observation group was treated with lithium carbonate and sodium valproate.Four weeks later,the manic conditions were assessed with Baker-Lafferson Mania Scale(BRMS),psychiatric symptoms were evaluated with Positive and Negative symptom scales(PANSS),the cognitive function was evaluated with wisconsin classification test(WCT),verbal memory test(VMT),continuous operation test(CPT),and the adverse reaction were assessed with side effects scales.Results After treatment,both BRMS scores and PANSS scores decreased compared with before treatment,and the observation group was lower than the control group;WCST score,HVLT-R score,and CPT score were all increased compared with before treatment,and the observation group Significantly higher than the control group.The WCST score and HVLT-R score in the control group had no significant difference before treatment;the total effective rate in the control group was 84%,and the total effective rate in the observation group was 94.7%.,significantly higher than the control group;adverse reactions in the control group was 76.0%,29.3%in the observation group,significantly lower than the control group.Conclusion The use of lithium carbonate combined with sodium valproate in the treatment of patients with manic episodes of bipolar disorder can significantly improve the clinical efficacy and safety,and can effectively improve the cognitive function of patients,significantly better than single lithium carbonate treatment,worthy of extensive clinical applications.
作者 李小兰 贾璐 Li Xiao-lan;Jia Lu(Department of Psychiatry,Fengdu County Psychiatric Hospital,Chongqing 408200,China;Department of Psychosomatic Medicine,Ninth People's Hospital of Chongqing,Chonaqing 400700,China)
出处 《湖南师范大学学报(医学版)》 2019年第2期39-41,共3页 Journal of Hunan Normal University(Medical Sciences)
基金 丁螺环酮对精神分裂症患者康复期认知功能作用的研究(NO.FC2017034001)
关键词 双相情感障碍 躁狂发作 碳酸锂 丙戊酸钠 bipolar disorder manic episode lithium carbonate sodium valproate
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