四川医学
四川醫學
사천의학
Sichuan Medical Journal
2015年
8期
1135-1138
,共4页
熊联慧%周田%曾永涛%葛乾荣
熊聯慧%週田%曾永濤%葛乾榮
웅련혜%주전%증영도%갈건영
不典型抗精神病药物%心境稳定剂%抗抑郁剂%双相障碍
不典型抗精神病藥物%心境穩定劑%抗抑鬱劑%雙相障礙
불전형항정신병약물%심경은정제%항억욱제%쌍상장애
atypical antipsychotics%mood stabilizer%antidepressant%bipolar disorder
目的 观察不典型抗精神病药物、心境稳定剂及抗抑郁剂对双相障碍患者的维持治疗1年的结局. 方法选择符合ICD-10双相障碍诊断标准患者,急性期进行8周抗抑郁剂和心境稳定剂丙戊酸镁和喹硫平联合治疗,痊愈和有效者分别联用和不联用抗抑郁剂进入1年的维持治疗期. 用17项汉密尔顿抑郁量表( HAMD)、躁狂量表( BRMS)和临床疗效总评量表( CGI)评定疾病严重程度和疗效. 结果 120例患者急性期治疗后按就诊奇偶顺序随机分研究组(联用抗抑郁剂组,61例)和对照组(未取用抗抑郁药组,59例). 随访1年后,研究组61例共有40例维持痊愈,14例有效,5例症状复发,转躁2例,总发病率为11%;对照组59例随访1年后痊愈32例,有效10例,复发15例,转躁2例,总发病率为29%,两组差异有统计学意义(P<0. 05). 联用抗忧郁剂组复发率明显低于未联用抗抑郁剂组,转躁率无明显差异. 生成分析显示联用抗抑郁剂组平均复发时间显著长于未联用抗抑郁组. 结论 不典型抗精神病药物、心境稳定剂及抗抑郁剂治疗双相障碍患者1年后复发率低,转躁率无明显差异.
目的 觀察不典型抗精神病藥物、心境穩定劑及抗抑鬱劑對雙相障礙患者的維持治療1年的結跼. 方法選擇符閤ICD-10雙相障礙診斷標準患者,急性期進行8週抗抑鬱劑和心境穩定劑丙戊痠鎂和喹硫平聯閤治療,痊愈和有效者分彆聯用和不聯用抗抑鬱劑進入1年的維持治療期. 用17項漢密爾頓抑鬱量錶( HAMD)、躁狂量錶( BRMS)和臨床療效總評量錶( CGI)評定疾病嚴重程度和療效. 結果 120例患者急性期治療後按就診奇偶順序隨機分研究組(聯用抗抑鬱劑組,61例)和對照組(未取用抗抑鬱藥組,59例). 隨訪1年後,研究組61例共有40例維持痊愈,14例有效,5例癥狀複髮,轉躁2例,總髮病率為11%;對照組59例隨訪1年後痊愈32例,有效10例,複髮15例,轉躁2例,總髮病率為29%,兩組差異有統計學意義(P<0. 05). 聯用抗憂鬱劑組複髮率明顯低于未聯用抗抑鬱劑組,轉躁率無明顯差異. 生成分析顯示聯用抗抑鬱劑組平均複髮時間顯著長于未聯用抗抑鬱組. 結論 不典型抗精神病藥物、心境穩定劑及抗抑鬱劑治療雙相障礙患者1年後複髮率低,轉躁率無明顯差異.
목적 관찰불전형항정신병약물、심경은정제급항억욱제대쌍상장애환자적유지치료1년적결국. 방법선택부합ICD-10쌍상장애진단표준환자,급성기진행8주항억욱제화심경은정제병무산미화규류평연합치료,전유화유효자분별련용화불련용항억욱제진입1년적유지치료기. 용17항한밀이돈억욱량표( HAMD)、조광량표( BRMS)화림상료효총평량표( CGI)평정질병엄중정도화료효. 결과 120례환자급성기치료후안취진기우순서수궤분연구조(련용항억욱제조,61례)화대조조(미취용항억욱약조,59례). 수방1년후,연구조61례공유40례유지전유,14례유효,5례증상복발,전조2례,총발병솔위11%;대조조59례수방1년후전유32례,유효10례,복발15례,전조2례,총발병솔위29%,량조차이유통계학의의(P<0. 05). 련용항우욱제조복발솔명현저우미련용항억욱제조,전조솔무명현차이. 생성분석현시련용항억욱제조평균복발시간현저장우미련용항억욱조. 결론 불전형항정신병약물、심경은정제급항억욱제치료쌍상장애환자1년후복발솔저,전조솔무명현차이.
Objective To explore 1-year outcomes of patients with bipolar disrorder treated with atypical antipsychotics and mood stabilizer which combined with antidepressant. Methods Patients who met the bipolar disorder criterion of ICD-10(In-ternational Classification of Disease) were treated in 8-week acute period by atypical antipsychotics and mood stabilizer combined with antidepressant. Patients with remission and response after acute treatment participated in 1-year continuation of their medica-tion. 17 items Hamilton depression rating scale ( HAMD) ,Bech-Rafaelsen mania rating scale ( BRMS) and clinical global impres-sion(CGI) were employed to assess diseases severity and the outcome. Results After the acute treatment, 120 patients were ran-domly divided into the study group (61)( combined with antidepressant) and the control group (59). After the 1-year continuous treatment, At the study group, there were 40 patients maintaining remission and 14 patients response, 5 patients relapsed, 2 pa-tients mania relapsed. The relapse rate was 11 %. on the control group, there were 32 patients maintaining remission and 10 pa-tients response, 15 patients relapsed. 2 patients mania relapsed. The relapse rate was 29%. There were significantly difference in remission rate between the study group and the control group. The depression relapse rate in the study group was significant lower than that of control group. while the mania relapse rate was no significantly different between two groups. The mean time to relapse in the study group was longer than the control group. Conclusion 1-yaer outcome of patients with bipolar disrorder treated with a-typical antipsychotics and mood stabilizer combined with antidepressant was low relapses rate,but the mania relapse rate was no significantly different.
