奎硫平与碳酸锂治疗双相障碍躁狂发作对照研究

目的 探讨奎硫平与碳酸锂治疗双相障碍躁狂发作的临床疗效和安全性. 方法 将84例双相障碍躁狂发作患者随机分为两组,各42例,研究组口服奎硫平治疗,对照组口服碳酸锂治疗,观察8周.于治疗前及治疗第1周、2周、4周、6周、8周末采用Beck-Rafaelsen躁狂量表及临床总体印象量表评定临床疗效,副反应量表评定不良反应. 结果 治疗后两组躁狂量表及临床总体印象量表总分均较治疗前显著下降（P＜0.01）,研究组治疗1周、2周末临床总体印象量表评分显著低于对照组（P＜0.01）,2周、4周末躁狂量表评分显著低于对照组（P＜0.05或0.01）;治疗8周末研究组显效率85.7%、总有效率95.24%,对照组分别为88.1%、95.24%,两组疗效无显著性差异（P＞0.05）.两组不良反应发生率无显著性差异（P＞0.05）. 结论 奎硫平治疗双相障碍躁狂发作疗效显著,且与碳酸锂相当,安全性高,但较碳酸锂起效更快,且不需常规监测血药浓度,更适合在基层社区应用.

A control study of quetiapine vs. lithium carbonate in the treatment of the therapy of bipolar disorder manic episode

Objective To explore the efficacy and safety of quetiapine vs. lithium carbonate in the treatment of bipolar disorder manic episode （BDME）. Methods Eighty-four BDME patients were randomly assigned to two groups of 42 ones each, research group took orally quetiapine and control group did lithium carbonate for 8 weeks. Clinical efficacies were assessed with the Beck-Rafaelsen Mania Scale （BRMS）, Clinical Global Impression （CGI） and Treatment Emergent Symptom Scale （TESS） before treatment and at the end of the 1st, 2nd, 4th, 6th and 8th week. Results The total scores of the BRMS and CGI of both groups lowered more significantly after treatment compared with pretreatment （P〈0.01）, both the scores of the CGI at the end of the 1st and 2nd week （P〈0.01） and those of the BRMS at the end of the 2nd and 4th week （P〈0.05 or 0.01） were significantly lower in the research than in the control group; at the end of the 8th week, obvious and total effective rates were 85.7% and 95.24% in the research and 88.1% and 95, 24% in the control group respectively, which showed no significant differences （P〉0.05）. There were no significant differences in incidences of adverse reactions between the 2 groups （P〉0.05）. Conclusion Quetiapine has an evident effect equivalent to lithium carbonate and higher safety, but the former takes effect more rapidly, doesn＇t need routine monitoring of blood drug level and is more suitable to utilize in community.