河北省双相障碍患者药物治疗现状的调查分析

目的:为促进河北省双相障碍患者治疗的规范化、合理化,特别是为提高基层的临床治疗水平提供参考。方法:选取在河北省39家精神专科医院或综合医院精神科接受精神药物治疗的门诊或住院双相障碍患者,通过问卷调查患者的药物治疗情况,并对数据进行统计分析。结果:共发放问卷521份,回收有效问卷519份,有效回收率为99.6%。397例(76.5%)患者接受心境稳定剂治疗,使用频率排前3位的分别为丙戊酸钠、碳酸锂和丙戊酸镁;455例(87.7%)患者接受抗精神病药治疗,使用频率排前5位的分别为喹硫平、奥氮平、利培酮、氯氮平和阿立哌唑;89例(17.1%)患者接受抗抑郁药治疗,其中73.0%使用选择性5-羟色胺再摄取抑制剂;154例(29.7%)患者接受苯二氮类药物治疗,47例(9.1%)患者辅以抗胆碱药物治疗,27例(5.2%)患者辅以β受体阻滞药治疗。双相障碍治疗以联合用药为主,428例(82.5%)患者联合2种以上精神药物治疗,以心境稳定剂联合抗精神病药为主;且抗抑郁药使用以联合心境稳定剂或抗精神病药为主。住院患者心境稳定剂的使用与门诊患者比较,差异有统计学意义(P<0.01),丙戊酸钠的使用频率低于门诊患者,碳酸锂和丙戊酸镁的使用频率高于门诊患者;住院患者接受抗抑郁药治疗的比例显著低于门诊患者,二者比较差异有统计学意义(P<0.05)。结论:河北省双相障碍患者的治疗以心境稳定剂联合抗精神病药为主要的方式;抗精神病药的使用比例较高,以非典型抗精神病药为主;抗抑郁药的使用以联合用药为主;心境稳定剂在住院与门诊的选择有所不同,且抗抑郁药门诊使用比例较高。双相障碍患者的治疗总体符合双相障碍防治指南的推荐用药原则。

Investigation and Analysis of Drug Therapy for Bipolar Disorders Patients in Hebei Province

OBJECTIVE：To promote standard and reasonable therapy for bipolar disorder patients in Hebei province,and to provide reference for the improvement of clinical treatment. METHODS：The outpatients and inpatients receiving psychotropic drug therapy in psychiatry departments of 39 psychiatric hospitals or general hospitals were collected and investigated about drug therapy by using questionnaires. And then data was analyzed statistically. RESULTS：521 questionnaires were distributed,and 519 valid questionnaires were collected with effective recovery rate of 99.6%. The mood stabilizers were used in 397 patients（76.5%）,and top 3 drugs in the list of frequency were valproate,lithium and magnesium valproate;the antipsyehotics were used in 455 patients（87.7%）,and top 5 drugs in the list of frequency were quetiapine,olanzapine,risperidone,clozapine and aripiprazole;89 cases（17.1%）received antidepressants,73.0% of which used selective 5-serotonin reuptake inhibitors;154 cases（29.7%）used benzodiazepine drugs,47 cases（9.1%）received anticholinergic drug secondarily,and 27 cases（5.2%）were given adjunctive therapy of β-blockers. Bipolar disorders therapy mainly was combination therapy;428 patients were treated with two or more psychotropic drugs（82.5%）;which mainly were mood stabilizers combined with antipsychotics. Antidepressants mainly were combination therapy of mood stabilizers or antipsychotics. There was no statistical significance in the utilization of mood stabilizers between inpatients and outpatients（P〈0.01）. The frequency of sodium valproate used in the inpatients was lower than in the outpatients;the frequency of lithium carbonate and magnesium valproate in the inpatients was higher than in the outpatients;the proportion of inpatients receiving antidepressants was significantly lower than that of outpatients;there was statistical significance（P〈0.05）. CONCLUSIONS：Antipsychotics combined with mood stabilizers is the first line choice for bipolar disorder in Hebei province