N-乙酰半胱氨酸辅助治疗双相障碍抑郁症状的对照研究

目的 观察N-乙酰半胱氨酸(NAC)联合丙戊酸钠和帕罗西汀治疗双相障碍抑郁发作的疗效.方法 收集双相障碍抑郁发作患者50例,随机分为两组,在充分应用心境稳定剂丙戊酸钠和抗抑郁药帕罗西汀基础上,研究组(28例)加用NAC治疗,对照组(22例)不加用NAC,分别于治疗前及治疗第4周、第8周和第10周采用汉密尔顿抑郁量表(HAMD-17)评定疗效,采用不良反应量表(TESS)评定治疗中出现的不良反应.结果 两组间HAMD-17评分在治疗第8周和第10周差异均有统计学意义(t分别=2.49、3.47,P均＜0.05),研究组第10周临床治愈率(89.29％)高于对照组(63.64％),差异有统计学意义(x2=4.72,P＜ 0.05).两组TESS评分比较差异无统计学意义(t=0.13,P＞ 0.05).结论 N-乙酰半胱氨酸对双相障碍抑郁发作有一定的辅助治疗作用.

N-acetyleysteine add on treatment for depressive symptoms in bipolar disorder：a comparative trial

Objective To investigate the therapeutic effectiveness and safety of N-acety] cysteine for depressive symptoms in bipolar disorder humans. Methods A randomized comparative study of individuals（n=50） with bipolar disorder in the maintenance phase treated with NAC adjunctive to usual medication （valproate and paroxetine）over 10 weeks. Participants were assessed at baseline,4 weeks,and 8 weeks and 10 weeks using the Hamilton rating scale （HAMD-17） for depression. The Treatment emergent symptom scale（TESS） was used to find adverse events. Results NAC treatment caused a significant decline on the HAMD-17 （t=3.47,P〈0.05） at end point. Benefit was evident by 8 weeks on the HAMD-17 （t=2.49,P〈0.05）. At end point,the remission rate of NAC treatment group was higher than that of the control group （89.29% vs. 63.64%）（X2=4.72,P〈0.05）. There was no significant differences between the two groups in adverse events. Conclusions NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.