喹硫平与丙戊酸镁治疗双相障碍躁狂发作的对照研究

目的:探讨喹硫平对双相障碍躁狂发作的疗效及依从性。方法:将100例双相障碍躁狂发作住院患者随机分为两组,分别给予喹硫平与丙戊酸镁治疗,疗程为8周。用倍克-拉范森躁狂量表(BRMS)评定疗效,用副反应量表(TESS)评定不良反应。结果:治疗后喹硫平组BRMS分值明显下降(基线为32±7;第8周5±2);丙戊酸镁组BRMS分值也明显下降(基线为31±7;第8周6±2)。喹硫平组与丙戊酸镁组从第2周BRMS分值下降都比较明显,疗效无显著性差异(t=2.875,P>0.05);第8周末喹硫平组临床痊愈率为52%,丙戊酸镁组临床痊愈率为50%,(x2=1.357,P>0.05)未见明显差异,不良反应发生率无明显差异,均在用药早期出现。喹硫平组随着治疗延续而逐渐耐受,临床脱落率为8%,而丙戊酸镁组随着剂量增高而上述症状加重,临床脱落率为18%,两组脱落率有显著性差异(P<0.01)。结论:喹硫平与丙戊酸镁对双相躁狂发作皆有较好疗效,疗效相当。喹硫平治疗依从性更高。

A control study of Quetiapine and Magnesium valproate for the treatment of bipolar disorder

Objective:To explore the efficacy and compliance of Quetiapine in the treatment of bipolar mania.Methods:100 patients with bipolar mania were randly divided into two groups treated with Quetiapine and Magnesium valproate respectively for 8 weeks.The efficacy and side effects were evaluted with Bech-Rafaelsen Mania Rating Scale(BRMS) and treatment emergent symptoms(TESS).Results: After treatment,BRMS scores decreased significantly in the Quetiapine group as well as in the Magnesium valproate group(Quetiapine group: 32±7 at baseline and 5±2 at week 8;Magnesium valproate group :31±7 and 6±2,respectively).The score of BRMS of Quetiapine group and Magnesium valproate group from the second week decreased obviously.Efficacy was no significant difference between the two groups(t=2.875,P>0.05);At the end of 8 weeks after treatment,the clinical recovery rate of Quetiapine was 52%,while that was 50% in the Magnesium valproate group(x2=1.357,P>0.05) There was no significant difference in adverse reactions between two groups,both in the medication appeared in early.Adverse reactions in quetiapine group as treatment continues gradually tolerance,clinical loss rate of 8%,and Magnesium valproate group as the dose increased adverse symptoms,clinical loss rate of 18%,two groups of shedding rate had significant difference(P<0.01).Conclusions: Quetiapine is as effective as Magnesium valproate in treatment of bipolar maina,but Quetiapine with better medication compliance for patients.