CAJ | 학술논문

目的：探讨喹硫平合并丙戊酸镁缓释片治疗老年双相情感障碍躁狂发作的临床疗效和安全性。方法选择2013年5月至2014年5月在解放军第261医院，住院符合国际疾病分类-10（ICD-10）双相情感障碍躁狂发作诊断的46例患者，年龄60～78岁。46例符合ICD-10躁狂发作的老年患者随机分为喹硫平合并丙戊酸镁缓释片组（研究组）和单用丙戊酸镁缓释片组（对照组）。治疗6周，应用贝克?拉范森躁狂量表（BRMS）评定疗效，治疗意外症状量表（副反应量表，TESS）评定不良反应。结果治疗过程中每组BRMS总分都有显著下降（P＜0.05），治疗2周后研究组总分及因子分言语/吵闹、睡眠与对照组比较，差异存在统计学意义（P＜0.05）。治疗6周后，研究组与对照组临床总有效率差异无统计学意义（P＞0.05）。两组均无严重的药物不良反应，两组TESS评分差异无统计学意义（P＞0.05）。结论喹硫平和丙戊酸镁缓释片伍用治疗老年躁狂发作疗效较好，安全性较好，特别是在治疗初期（2周末）能更好的控制兴奋症状和改善睡眠。
목적：탐토규류평합병병무산미완석편치료노년쌍상정감장애조광발작적림상료효화안전성。방법선택2013년5월지2014년5월재해방군제261의원，주원부합국제질병분류-10（ICD-10）쌍상정감장애조광발작진단적46례환자，년령60～78세。46례부합ICD-10조광발작적노년환자수궤분위규류평합병병무산미완석편조（연구조）화단용병무산미완석편조（대조조）。치료6주，응용패극?랍범삼조광량표（BRMS）평정료효，치료의외증상량표（부반응량표，TESS）평정불량반응。결과치료과정중매조BRMS총분도유현저하강（P＜0.05），치료2주후연구조총분급인자분언어/묘료、수면여대조조비교，차이존재통계학의의（P＜0.05）。치료6주후，연구조여대조조림상총유효솔차이무통계학의의（P＞0.05）。량조균무엄중적약물불량반응，량조TESS평분차이무통계학의의（P＞0.05）。결론규류평화병무산미완석편오용치료노년조광발작료효교호，안전성교호，특별시재치료초기（2주말）능경호적공제흥강증상화개선수면。
ObjectiveTo determine the clinical efficacy and safety of magnesium valproate sustained release tablets and combination with quetiapine in treatment of manic episode in the elderly with bipolar disorder.MethodsA total of 46 elderly patients (aged 60 to 78 years) who met the criteria of the International Classification of Diseases (ICD-10) for manic episode of bipolar disorder admitted in our hospital from May 2013 to May 2014 were enrolled in this study. They were randomly assigned to 2 groups, and treated with magnesium valproate sustained release tablets (control group) or combined with quetiapine (study group). In 6 weeks after treatment, Bech-Rafaelsen Mania Rating Scale (BRMS) and Treatment Emergent Symptoms Scale (TESS) were employed to evaluate the clinical efficacy and adverse effects respectively.Results BRMS scores were dropped significantly in both groups (P<0.05). At the end of the second weeks, there were significant differences in the total score of BRMS and the factor points (noisy/speech, sleep) between the study and control groups (P<0.05). At the end of 6 weeks’ treatment, there was no significant difference in the total score of BRMS between the 2 groups (P>0.05). No severe adverse effect was seen in the both groups, and there was no significant difference in TESS score between them.Conclusion Magnesium valproate sustained release tablets combined with quetiapine show better efficacy and sound safety in the treatment of maniac episode in the elderly patients, especially in controlling excitement symptoms and improving sleep at the early stage of treatment (the end of 2 weeks).