【摘要】 目的 探讨碳酸锂联合喹硫平与联合丙戊酸镁缓释片治疗双相情感障碍躁狂发作的疗效以及对认知功能的影响。方法 将120例双相障碍躁狂发作患者按照治疗方法不同分为A、B、C3组,每组40例,3组均口服碳酸锂治疗,在此基础上B组联合口服喹硫平治疗,C组联合口服丙戍酸钠缓释片治疗,观察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,副反应量表评定不良反应,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。结果 治疗后3组贝克-拉范森躁狂量表及阳性与阴性症状量表评分均较治疗前显著下降(p<0.01).B组、C组评分显著低于A组(p<0.01);威斯康星片分类测验、言语记忆测验、持续操作测验评分均较治疗前有所提高,但B组、C组言语记忆测验、持续操作测验评分显著高于A组(P<0.05或0.01);B组有效率为97.5%、C组为95.0%、A组为77.5%,B组及C组有效率显著高于A组(P<0.05或0.01)。结论 碳酸锂联合喹硫乎与联合丙戊酸镁缓释片治疗双相情感障碍躁狂发作具有增效作用,疗效显著,安全性高,且能有效改善患者的认知功能,显著优于单用碳酸锂治疗,值得在临床推广应用。更多还原

【Abstract】 Objective To study the clinical effect of lithium carbonate(LC) combined with quetiapine tablets(QT) or magnesium valproate sustained release tablets(MVSRT) on treatment of manic episode in patients with bipolar disorder and their cognitive functions. Methods 120 patients with bipolar disorder who had manic episodes were selected and evnly divided into A,B, C three groups,one group was treated with LC and QT(Group B), one group was treated with MVSRT and LC(Group C), and one group was treated with LC(Group A). Four weeks later, the manic conditions were assessed with Baker-Rafaelsen Mania Rating Scale(BRMS), psychiatric symptoms were evaluated with Positive and Negative Symptom Scale(PANSS). the adverse reactions were assessed with side effects scale; the cognitive function was cvaluated with Wisconsin classification test(WCT), verbal memory test(VMT), and continuous perform ance test(CPT). Results After treatment,BPMS score and PANSS score in three groups significantly decreased(P<0. 01). and GroupB & C were significantly lower than Group A(P<O. 01): the WCT,VMT and CPT scores slightly inc-reased, the、VMT. CPT scores in Group A&. B were significantly higher than those in Group C(P<0.05 or 0. 01); the effective rates were 97.5% in Group B. 95. 0% in Group C and 77. 5% in Group A, respectively, and Croup B & C were significantly higher than Group A(P<0. 05 or 0. 01). Conclusion LC-QT or LC-MVSRT both have a synergistic effect for the treatment of manic epi.sode in patients with bipolar disorder, with significant efficacy and high safety, and they can effectively improve the patient’s cognitive function, significantly better than single Lithium carbonate treatment, worthy of extensive clinical applications.更多还原