碳酸锂联合喹硫平治疗双相情感障碍的临床研究

摘要

Objective To investigate the efficacy and safety of lithium carbonate combined with quetiapine in the treatment of bipolar disorder.Methods A total of 368bipolar disorder patients were collected in this study.180 patients in control group were treated with routine therapy and lithium carbonate,bidfor 8 weeks;and 188 patients in treatment group were treated with the routine treatment and lithium carbonate combined with quetiapine,bid for 8 weeks.The score in Hamilton Depression Scale-17(HAMD-17)and Positive and Negative SyndromeScale(PANSS)score were used to evaluate the recovery of two groups after 1,2,4 and 8 weeks.Meanwhile,the con-centration of IL-1,IL-10 and TNF-αin blood were detected before and 8weeks after treatment.The adverse reactions were valued by Treatment Emergent Symptom Scale(TESS)in two groups.Results After treatment,the clinical effect of patients in two groups were significantly improved compared with before treatment(P<0.05).The HAMD score and PANSS score of patients in treatment group were significantly better than those in control group(P<0.05).The total efficiency of treatment group(73.9%)was significantly higher than that of control group(50.5%,P<0.05).Two groups of patients with blood IL-1,IL-10 and TNF-αwere improved than before treatment,and the study group improved significantly(P<0.05).The incidence of adverse reactions in two groups had no significant difference(P>0.05).Conclusions Lithium carbonate combined with quetiapine is good to treat for bipolar disorder and do not in -crease the incidence of adverse reactions.%目的 观察碳酸锂联合喹硫平治疗双相情感障碍的临床疗效和安全性.方法 368例双相情感障碍患者随机分为对照组180例和观察组188例.对照组给予碳酸锂和喹硫平安慰剂治疗;观察组给予碳酸锂联合喹硫平治疗,每天2次,两组患者疗程均为8周.治疗1、2、4、8周后,用17项汉密顿抑郁量表(HAMD-17)评分和阳性与阴性症状量表(PANSS)评价两组患者的恢复情况,同时在治疗前和治疗8周后检测患者血液中白细胞介素(IL)-1,IL-10和肿瘤坏死因子-α(TNF-α)浓度并比较.采用药物不良反应量表(TESS)评估药物引起的副作用.结果 两组患者治疗8周后,临床症状明显改善(P<0.05);并且观察组HAMD评分和PANSS评分明显优于对照组(P<0.05).观察组治疗后显效率为73.9%,显著高于对照组的50.5%(P<0.05).两组患者血液中IL-1,IL-10和TNF-α较治疗前均有所改善,且观察组患者改善更加明显(P<0.05).两组不良反应发生率差异无统计学意义(P>0.05).结论 碳酸锂联合喹硫平治疗双相情感障碍临床疗效显著,且不增加不良反应的发生率.