目的：探讨奥氮平联合丙戊酸镁缓释片治疗以冲动攻击为主的脑外伤所致人格改变的疗效与安全性。方法：将51例根据中国精神障碍分类与诊断标准第3版(CCMD-3)确诊为脑外伤所致人格改变的患者随机分为实验组(25例)和对照组(26例)。实验组患者应用奥氮平、丙戊酸镁缓释片，对照组患者应用丙戊酸镁缓释片治疗，疗程8周。两组患者于治疗前及治疗第1、2、4、6、8周时使用修改版外显攻击行为量表( MOAS)及副反应量表( TESS)评定临床疗效和不良反应。结果：两组患者间在治疗2周末起MOAS评分比较差异均有统计学意义(P<0.05)，实验组患者评分降低更为明显，两组患者不良反应多为轻度，可耐受。结论：奥氮平合并丙戊酸镁缓释片治疗以冲动攻击为主的脑外伤所致人格改变起效更快，疗效好且安全，可快速控制冲动攻击行为。%Objective:To investigate effects and safety of olanzapine combined with magnesium valproate sustained-release tablets on personality change after traumatic brain injury. Methods:A total of 51 patients with personality change after traumatic brain injury diagnosed according to Chinese classification and diagnostic criteria of mental disorders 3rd edition (CCMD-3) were randomly divided into experimental group (25 cases) and control group (26 cases). The cases in experimental group were given olanzapine com-bined with magnesium valproate sustained-release tablets for 8 weeks, whereas those in control group were only given magnesium val-proate sustained release tablets for 8 weeks. The modified overt aggression scales ( MOAS) and treatment emergent symptom scale ( TESS) were used to evaluate the effects and adverse reactions for the two groups before and 1, 2, 4, 6, and 8 weeks after the treat-ment. Results:Starting from 2 weeks after the treatment, the differences of MOAS scores between the two groups were statistically sig-nificant (P<0. 05), and the MOAS scores of experimental group were much lower. The two groups both had mild and tolerable adverse reactions. Conclusions: In the treatment of personality change after traumatic brain injury, olanzapine combined with magnesium val-proate sustained tablets can take effects faster, is effective and safe, and can rapidly control the impulsive aggressive behavior.
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