Objective To explore the efficacy and safety of lithium carbonate sustained‐release tablets (LCSRTs) plus ziprasidone sequential treatment for manic episode of bipolar disorder (MEBD) .Methods A total of 100 MEBD patients were randomly divided into two groups of 50 ones each ,both groups took o‐rally LCSRTs ,observation was plus ziprasidone sequential treatment and control group plus oral quetiap‐ine for 8 weeks .Efficacies were assessed with the Bech‐Rafaelsen Mania Rating Scale (BRMS) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results Since the end of the 1st week the BRMS scores of both groups lowered more significantly compared with pretreatment (P<0 .01) ,that was significantly lower in observation than in control group at the end of the 2nd week (P<0 .05);at the end of the 8th week the total effective rate was respectively 92 .0% in observa‐tion and 90 .0% in control group ,which showed no significant group difference (P>0 .05) .Adverse reac‐tions of both groups were mild ,the incidences of adverse reactions was 44 .0% in observation group ,that of ECG abnormality higher ;the incidences of adverse reactions was 48 .0% in control group ,those of men‐struation changes and lactation were higher .There was no significant group difference in the incidence of adverse reactions (P>0 .05) .Conclusion LCSRTs plus ziprasidone sequential treatment for MEBD take effect more rapidly and have an evident effect and higher safety .%目的：探讨碳酸锂缓释片联合齐拉西酮序贯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按随机数字表法分为两组，每组50例，均口服碳酸锂缓释片治疗，观察组联合齐拉西酮序贯治疗，对照组联合口服喹硫平治疗，观察8周。治疗前后采用Bech‐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1周末起两组Bech‐Rafaelsen躁狂量表评分均较治疗前显著下降（P＜0．01），观察组治疗第2周末评分显著低于对照组（ P＜0．05）；治疗8周末观察组总有效率为92．0％，对照组为90．0％，两组总有效率比较差异无显著性（ P＞0．05）。两组不良反应均较轻微，观察组不良反应发生率为44．0％，其中心电图异常发生率较高；对照组不良反应发生率为48．0％，其中在月经改变和泌乳的发生率较高。两组不良反应发生率比较差异无显著性（P＞0．05）。结论碳酸锂缓释片联合齐拉西酮序贯治疗双相障碍躁狂发作起效快，疗效显著，安全性高。
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