齐拉西酮联合心境稳定剂治疗双相障碍躁狂发作和混合发作

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (1): 78-82.

齐拉西酮联合心境稳定剂治疗双相障碍躁狂发作和混合发作

任志斌, 陈正昕, 金卫东, 马永春, 陈炯, 邢葆平, 王鹤秋

浙江省立同德医院、浙江省精神卫生研究院,杭州 310012,浙江

收稿日期:2011-11-08 修回日期:2011-11-08 发布日期:2013-02-05
通讯作者: 金卫东,通信作者,男,主任医师,研究方向:精神药理学、儿童精神病学。E-mail: wdjin@163.com 13588480677
作者简介:任志斌,男,学士,主治医师,研究方向:临床精神药理学、儿童精神病学。 Tel: 13857176543 E-mail: Renzhibin80@163.com

Ziprasidone plus a mood stabilizer in subjects with patients with manic or mixed episode of bipolar disorders

REN Zhi-bin, CHEN Zheng-xin, JIN Wei-dong, MA Yong-chun, CHEN Jiong, XING Bao-ping, WANG He-qiu

Zhejiang Province Tongde Hospital, Zhejiang Province Mental Health Institute, Hangzhou 310012, Zhejiang, China

Received:2011-11-08 Revised:2011-11-08 Published:2013-02-05

摘要/Abstract

摘要： 目的: 探讨齐拉西酮合并碳酸锂或丙戊酸钠治疗躁狂发作和混合发作的疗效和安全性。方法: 对符合CCMD-3躁狂发作和混合发作诊断标准的68例研究对象随机分成两组,试验组应用齐拉西酮合并碳酸锂或丙戊酸钠,对照组单一使用碳酸锂或丙戊酸钠,治疗观察6周。采用杨氏躁狂量表(YMRS)评定疗效,以副反应量表(TESS)及实验室有关辅助检查评价安全性。结果: 两组在治疗前后症状均有显著降低(F=9.05,P<0.01;F=6.10,P<0.01)。试验组在治疗第1周末的减分率比对照组显著,这种差异在1~6周持续存在,而且第6周结束后的临床痊愈率也显著高于对照组。试验组治疗1周末、治疗2周末、治疗4周末、治疗6周末YMRS分别是 21.4±8.4、14.6±5.5、8.9±3.3、6.5±3.4,对照组分别是 23.9±7.2、20.9±8.1、17.8±7.8、12.8±8.9,组间差异有统计学意义(P<0.01)。试验组的症状减分变化分别是 6.1±3.5、12.9±4.8、20.1±5.3、21.4±5.5,对照组分别是2.1±3.0,6.8±4.5、11.5±5.6、14.4±5.3,组间比较差异有统计学意义(P<0.01)。两组间有效率差异有统计学意义(68.5% vs48.5%, χ²=4.47,P<0.05)。两组间痊愈率差异具有统计学意义(54.3% vs18.2%,χ²=9.52,P<0.01)。但是两组间均没有严重的药物副作用,因无疗效和副作用导致的脱落率两组差异无统计学意义。结论: 齐拉西酮合并碳酸锂或丙戊酸钠治疗躁狂发作和混合发作双相障碍的疗效比较理想,比单一使用心境稳定剂可能更好。

关键词: 齐拉西酮, 心境稳定剂, 躁狂发作, 混合发作, 双相障碍

Abstract: AIM: To explore efficacy and safety of ziprasidone combining lithium carbonate or valproate in the treatment of patients with manic and mixed episode of bipolar disorders. METHODS: The 68 patients meeting criteria of manic episode or mixed episode of bipolar disorder in CCMD-3 were randomly divided into experiment group( combination of ziprasidone and lithium carbonate or valproate) and control group( single using of lithium carbonate or valproate) and observed for 6 weeks.The Yong Manic Rating Scale(YMRS) and treatment emergent symptom scale(TESS)were individually used for the assessment of efficacy and safety.RESULTS: The score of YMRS was decreased significantly in the both groups after treatment(F=9.05,P<0.01;F=6.10,P<0.01).And the score of YMRS at 1st weekend in experiment group was significantly higher than that in control group,and this difference sustained for 6 weeks.The cure rate in experiment group was higher than that in control group after treating for 6 weeks.The scores of YMRS in experiment group were 21.4±8.4,14.6±5.5,8.9±3.3,6.5±3.4,respectively at 1 weekend, 2 weekend and 3 weekend;and the scores of YMRS in control group were 23.9±7.2,20.9±8.1,17.8±7.8,12.8±8.9,respectively.There was significant difference between the experiment group and control group(P<0.01). The changes of decreasing score of symptoms were in experiment group 6.1±3.5,12.9±4.8,20.1±5.3,21.4±5.5; and the changes of decreasing score of symptoms in control group were 2.1±3.0,6.8±4.5,11.5±5.6,14.4±5.3,respectively. There was significant difference between the experiment group and control group(P<0.01). The effective rate and cure rate in experiment group was significantly higher than that in control group(68.5% vs 48.5%, χ²=4.47,P<0.05;54.3%vs 18.2%, χ²=9.52,P<0.01). Both groups have not serious side effects. There were no difference in dropout rate due to less efficacy and side effects. CONCLUSION: The effects of ziprasidone combination with lithium carbonate or valproate in the treatment of manic episode and mixed episode of bipolar disorder is better than that of single lithium carbonate or valproate.

Key words: Ziprasidone, Mood stabilizers, Manic episode, Mixed episode, Bipolar disorder

中图分类号:

R749

任志斌, 陈正昕, 金卫东, 马永春, 陈炯, 邢葆平, 王鹤秋. 齐拉西酮联合心境稳定剂治疗双相障碍躁狂发作和混合发作[J]. 中国临床药理学与治疗学, 2013, 18(1): 78-82.

REN Zhi-bin, CHEN Zheng-xin, JIN Wei-dong, MA Yong-chun, CHEN Jiong, XING Bao-ping, WANG He-qiu. Ziprasidone plus a mood stabilizer in subjects with patients with manic or mixed episode of bipolar disorders[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(1): 78-82.

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