奎硫平与利培酮合并丙戊酸钠治疗躁狂发作的临床对照研究(1)
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[摘要] 目的：观察奎硫平与利培酮分别合并丙戊酸钠治疗躁狂发作的临床疗效和安全性。方法：将符合CCMD-3中各型躁狂发作诊断标准的60例患者随机分成两组(每组30例)，分别在使用奎硫平和利培酮口崩片的同时给予丙戊酸钠治疗，观察8周。采用Bech-Rafaelsen躁狂量表(BRMS)减分率评定疗效，采用副反应(TESS)及相关辅助检查评定耐受性。结果：治疗8周后，奎硫平与利培酮合并丙戊酸钠治疗躁狂发作总体疗效比较，差异无统计学意义(P>0.05)，利培酮组锥体外系不良反应发生率明显高于奎硫平组(P<0.05)。结论：奎硫平与利培酮合并丙戊醉钠治疗躁狂发作疗效相当，但奎硫平组不良反应较小。
[关键词] 奎硫平；利培酮；丙戊酸钠；躁狂症
[中图分类号] R971+.43 [文献标识码] A [文章编号] 1673-7210(2011)06(c)-092-02
Clinical controlled study on quetiapine and risperidone orallydisintegrating combined with sodium valproate tablets in mania patients
ZHANG Fusong
The Fifth People′s Hospital of Kaifeng City, He′nan Province, Kaifeng 475003, China
[Abstract] Objective: To observe the efficacy and safety of quetiapine and risperidone combined with sodium valproate tablets in treatment of mania patients. Methods: 60 patients meeting the criteria of CCMD-3 for maina were randomly divided into two groups(each 30 cases), patients in two groups were gaven quetiapine and risperidone orally disintegrating tablets separately, and both combined with sodium valproate tablets, they were treated for 8 weeks. Clinical efficacy and the safety were evaluated with Bech-Rafaelsen mania rating scale(BRMS) and treatment emergent symptom scale(TESS)affiliated related examinations separately. Results: By the end of 8 weeks, the difference of the effect of two groups was not significant(P>0.05), but the rate of extrapyramidal side effects in risperidone group was higher than quetiapine group(P<0.05). Conclusion: Quetiapine is as effective as risperidone orally disintegrating tablets combined with sodium valproate tablets in treatment of mania patients, but lower scores of side effects were showed in patients treated with quetiapine.
[Key words] Quetiapine; Risperidone orally disintegrating tablets; Sodium valproate tablets; Mania
抗癫痫药丙戊酸钠作为情绪稳定剂治疗躁狂发作已经广泛应用于临床，但单一的应用丙戊酸钠治疗躁狂发作起效较慢，且缺乏抗精神病作用。近年来，非典型抗精神病药物治疗双相躁狂及躁狂发作的文献越来越多，特别是对奎硫平的研究，它可以单独或者联合心境稳定剂治疗躁狂发作。为此，笔者进行了如下临床对照研究，现报道如下：
1 资料与方法
1.1 一般资料
选择2008年10月～2011年1月在开封市第五人民医院就诊的情感性精神障碍躁狂发作的门诊或住院患者，符合中国精神疾病分类与诊断标准第三版(CCMD-3)单次躁狂发作、反复躁狂发作、双相障碍躁狂相、混合相、有精神病症状的躁狂发作的诊断标准 ......
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