喹硫平与碳酸锂治疗双相情感障碍躁狂发作对照研究

目的 探讨喹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100例双相障碍躁狂发作患者随机分为两组,每组50例,研究组口服喹硫平治疗,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总分减分率均呈持续性升高(P<0.01);治疗8周末,研究组痊愈率40.0%、有效率56.0%,对照组分别为38.0%、58.0%,两组差异无显著性(P>0.05);研究组不良反应发生率为24.0%,对照组为48.0%,研究组显著低于对照组(X2-6.25,P<0.05).结论 喹硫平与碳酸锂治疗双相障碍躁狂发作疗效显著,总体疗效相当,但喹硫平不良反应较轻微,不需要常规监测血药浓度,安伞性更高,可作为治疗双相情感障碍躁狂发作的一线用药.

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

Objective To explore the efficacy and safety of quetiapine vs. lithium carbonate in the treatment of manic episode of bipolar disorder. Methods One hundred bipolar mania patients were randomly assigned to research group （n=50） took orally quetiapine and control group （n：50） did lithium carbonate for 8 weeks. Efficacies were assessed with the Beck-Rafaelsen Mania Scale （BRMS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before and at the end of the 1^St , 2^na, 4^th , 6＆th and 8^th week treatment. Results The reducing score rate of the BRMS total score continously heightened after treatment in both groups （P〈0.01） ; at the end of the 8th week, cure and effective rates were 40.0% and 56.0% in the research and 38.0% and 58.0% in the control group, which showed no signficant differences （P〉0.05）;the incidence of adverse reactions was significantly lower in the research than in the control group （24.0%vs. 48.0%, x^2=6. 25,P〈0.05）. Conclusion Quetiapine vs. lithium carbonate have same significant efficacy in manic episode of bipolar disorder, but quetiapine＇s adverse reactions are mild and blood drug level doesn＇t need routine monitoring, has higher safety and can be used as first-line drug for manic episode of bipolar disorder.