碳酸锂合并典型和非典型抗精神病药治疗双相障碍躁狂发作的1年随访

目的:研究分析碳酸锂合并典型和非典型抗精神病药治疗双相障碍躁狂发作患者1年的治疗效果。方法:选取100例双相障碍躁狂发作的患者,随机分为典型组和非典型组各50例,典型组患者给予碳酸锂合并典型抗精神病药治疗,非典型组患者给予碳酸锂合并非典型抗精神病药治疗,随访1年。采用临床大体印象量表(CGI)、Bech-Rafaelsen躁狂量表(BRMS)、副反应量表(TESS)和药物依从性量表分别在患者治疗前和治疗后进行评定,比较两组患者治疗效果和安全性。结果:两组患者进行治疗后结果显示,非典型组患者治疗的总有效率为92.0%,其中有4例患者出现视物模糊、便秘、头晕、心电图异常等不良反应。典型组患者治疗的总有效率为78.0%,其中有11例患者出现心电图异常、头晕、嗜睡、扭转痉挛等不良反应。非典型组患者治疗的效果明显优于典型组。结论:碳酸锂合并非典型抗精神病药治疗双相障碍躁狂发作的治疗效果较好,不良反应较少,安全性较高,药物依从性好,具有一定的临床运用价值。

1 year follow-up of lithium carbonate combined with typical and atypical antipsychotics in treatment of manic episodes of bipolar disorder

Objective： To study and analyze effects of lithium carbonate combined with typical and atypical antipsy chotics in treatment of manic episodes in patients with bipolar disorder through 1 year follow- up. Methods： 100 patients with manic episodes of bipolar disorder were selected and randomly divided into typical group（ 50 cases） and atypical group（ 50 cases）. Typical group was given a typical antipsychotic combined with lithium carbonate,while atypical group was given lithium carbonate combined an atypical antipsy chotic,and they were followed up for 1 year. The patients were evaluated with clinical global impression scale（ CGI）,Bech-Rafaelsen mania rating scale（ BRMS）,treatment emergent symptom scale TESS（ TESS）,and medication adherence scale before and after the treatment. The treatment effects and safety of the two groups were compared. Results： After the treatment,the total effective rate of atypical group was 92. 0%,and 4 cases had the adverse reactions like blurred vision,constipation,dizziness,and abnormal electrocardiogram; the total effective rate of typical group was 78. 0%,and 11 cases had the adverse reactions like abnormal electrocardiogram,dizziness,somnolence,and torsion spasm. The treatment effect of atypical group was better than that of typical group. Conclusions： Lithium carbonate combined with atypical antipsychotics in the treatment of manic episodes of bipolar disorder treatment is better in the treatment effect,has fewer adverse reactions,higher safety and good drug compliance,and has a certain clinical application values.