刺五加联合碳酸锂对青少年双相障碍抑郁发作的疗效观察

目的:探讨刺五加联合碳酸锂对青少年双相障碍抑郁发作的疗效及不良反应。方法:连续收集门诊及住院的12-17岁双相障碍抑郁发作患者65例,采用随机双盲对照试验设计,将入选对象分为A组刺五加联合碳酸锂治疗组,B组氟西汀联合碳酸锂治疗组,疗程6周,以汉密尔顿抑郁量表(HAMD)减分情况评定疗效,不良反应症状量表(TESS)评定不良反应。结果:研究结束后有效病例63例(A组32例,B组31 例),脱落2例(均为B组)。进行意向(ITT)分析A组32例,B组33例,按符合方案(PP)分析前者32例, 后者31例。两组治疗后各周HAMD评分均较疗前有显著降低(P<0.001),治疗后各周A、B两组之间HAMD减分t检验,差异亦无显著性(P>0.05),疗程结束时两组显效率和有效率差异无显著性(P>0.05)。B组有2例治疗过程中出现病情转相,但转躁率两组之间无显著差异。结论:刺五加联合碳酸锂治疗青少年双相障碍抑郁发作有明显的效果,且无转躁发生,是安全有效的治疗方案。

Combining Acanthopanax Senticosus and Lithium Carbonate in the Treatment of Adolescent Bipolar Depression

Objective: To evaluate the clinical efficacy and safety of combining acanthopanax senticosus and lithium carbonate for the treatment of adolescent depression. Methods: 65 outpatients or inpatients were enrolled in a double-blind randomized clinical study which was conducted comparing combining acanthopanax senticosus and lithium versus combining fluoxetine and lithium for 6 weeks. Efficacy and side effects were assessed with Hamilton depression rating scale (HAMD) and treatment emergent symptom scale (TESS) respectively before and after the treatment. Results: 63 patients finished the trial, the rate of dropout was 3.08%. Altogether, 65 patients were enrolled in the study, only 32 were enrolled in ITT analysis and PP analysis in acanthopanax senticosus group, while 33 were enrolled in ITT analysis and 31 were eligible for PP analysis in fluoxetine group. The HAMD scores were significantly decreased after treatment at each weekly point in both groups. The difference of decreased HAMD scores between the two groups was not significant in weeks after treatment. At the end of treatment, the rate of utility and significant utility had no significant difference between the two groups. There were two patients who developed mania, while the rate of mania-conversion had no significant difference. Conclusion: Combined acanthopanax senticosus and lithium carbonate is an effect therapeutic scheme to adolescent bipolar depression.