碳酸锂单用与合并阿立哌唑治疗双相障碍I型躁狂发作患者的随机对照研究

摘要

目的：探讨碳酸锂单用及合并阿立哌唑治疗双相障碍 I 型躁狂发作患者的疗效和安全性。方法：86例门诊双相障碍 I 型躁狂发作患者被随机分为联合组（碳酸锂＋阿立哌唑治疗）和单药组（碳酸锂单药治疗），疗程8周。分别在治疗前、治疗2、4、8周进行杨氏躁狂量表（YMRS）和汉密顿抑郁量表（HAMD）-17项评定，采用治疗中出现的症状量表（ TESS）评定不良反应。结果：治疗前两组YMRS 评分差异无统计学意义；治疗2、4、8周后联合组 YMRS 减分值明显高于对照组（P ﹤0.05或 P ﹤0.01）；治疗前后两组 HAMD 均﹤7分；两组 TESS 评分差异无统计学意义。结论：碳酸锂联合阿立哌唑治疗双相障碍 I 型躁狂发作较单用碳酸锂起效快，症状改善更明显，且未见不良反应明显增加。%To investigate the clinical efficacy and safety of lithium carbonate monotherapy or combined aripiprazole therapy in patients with bipolar disorder type I manic episode. Method:Eighty-six out-patients with bipolar disorder type I manic episode were randomly divided into combining therapy group( trea-ted with lithium carbonate + aripiprazole)and monotherapy guoup(treated with lithium carbonate only),the course was 8 weeks. The patients were assessed by Young′s manic scale(YMRS)and Hamilton depression scale items(HAMD)-17 before treatment and 2,4,8 weeks after treatment. The adverse reaction was evaluated by treatment emergent symptoms scale(TESS). Results:Before treatment,the score of YMRS between the two groups was not significantly different. At 2,4,8 weeks after treatment the subtraction scores of YMRS in the combining therapy group were more obvious than the monotherapy guoup(P ﹤ 0. 05 or P ﹤ 0. 01). The scores of HAMD at each time point in the both groups were ﹤ 7. The score of TESS between the two groups was not signifi-cantly different. Conclusion:Compared lithium carbonate monotherapy,lithium carbonate combined aripi-prazole therapy in patients with bipolar disorder type I manic episode work fast,symptoms improved maybe more obviously,and no more adverse reactions.