孙华明，杨　姝，马　佳(齐齐哈尔市精神卫生中心精神科，黑龙江 齐齐哈尔　161006)



丙戊酸镁与氯硝西泮联合治疗躁狂症的疗效观察

孙华明*，杨姝，马佳(齐齐哈尔市精神卫生中心精神科，黑龙江 齐齐哈尔161006)

DOI10.14009/j.issn.1672-2124.2016.02.005

摘要目的：探讨丙戊酸镁与氯硝西泮联合治疗躁狂症的临床疗效。方法：选取齐齐哈尔市精神卫生中心2013年9月—2014年9月收治的躁狂症患者70例，按随机数字表法分为2组，观察组38例患者给予丙戊酸镁联合氯硝西泮治疗，对照组32例患者给予碳酸锂治疗；治疗结束后，使用贝克-拉范森躁狂量表(bech-rafaelsen,BRMS)评定药物起效时间，治疗前及治疗后1、2、4、6周的BRMS评分值、疗效和不良反应发生情况。结果：观察组患者治疗1周后BRMS评分为(1.61±1.3)分，2周后为(12.2±1.3)分，与对照组的(17.2±1.5)、(14.6±1.7)分比较，差异有统计学意义(P<0.05)，而观察组患者治疗4周后为(9.8±2.0)分，6周后为(7.1±1.2)分，与对照组的(12.9±2.1)、(10.3±2.3)分比较，差异无统计学意义(P>0.05)。观察组患者的总有效率为84.2%(32/38)，对照组为78.1%(25/32)，2组的差异无统计学意义(P>0.05)；观察组患者嗜睡4例，恶心1例，对照组患者嗜睡8例，恶心1例，增重2例，食欲下降1例，心电图异常1例，2组的差异有统计学意义(P<0.05)。结论：丙戊酸镁联合氯硝西泮治疗躁狂症的效果确切，不良反应少，安全、可靠，值得临床推广。

关键词丙戊酸镁； 氯硝西泮； 碳酸锂； 躁狂症

Observation on Efficacy of Magnesium Valproate Combined with Clonazepam in Treatment of Mania

SUN Huaming, YANG Shu, MA Jia(Dept.of Psychiatry, Qiqihaer Mental Health Center, Heilongjiang Qiqihaer 161006, China)

ABSTRACTOBJECTIVE：To probe into the clinical efficacy of magnesium valproate combined with clonazepam in treatment of mania. METHODS: 70 cases with mania admitted into Qiqihaer Mental Health Center from Sept. 2013 to Sept. 2014 were selected to be divided into two groups via the random number table, with 38 cases in each. The observation group were treated with magnesium valproate therapy combined with clonazepam, while the control group received lithium therapy; after treatment, the onset time of drug were evaluated by bech-rafaelsen (BRMS); before and after treatment of 1, 2, 4, 6 weeks, BRMS scores, efficacy and adverse reactions were recorded. RESULTS: After treatment of 1 week, BRMS scores of observation group were (1.61±1.3)scores, of control group were (17.2±1.5) scores； after treatment of two weeks, observation group were (12.2±1.3)scores, control group were (14.6±1.7) scores, the difference was statistically significant different between two groups(P<0.05). After treatment of 4 weeks and 6 weeks, the data in observation group were respectively (9.8±2.0) scores and (7.1±1.2) scores, in control group were (12.9±2.1) scores and (10.3±2.3) scores, without statistically significant difference (P>0.05). The effective rate of observation group was 84.2% (32/38), of control group was 78.1% (25/32), without statistically significant difference (P>0.05). There were 4 cases of sleepiness, a case of nausea in observation group; and 8 cases of sleepiness, a case of nausea, 2 cases of weight gain and 1 cases of electrocardiographic abnormality in control group; the difference was statistically significant(P<0.05). CONCLUSIONS: The effect of magnesium valproate combined with clonazepam in treatment of mania is significant, with few adverse reactions, which is safe, reliable and worthy of clinical application.

KEYWORDSMagnesium valproate; Clonazepam; Lithium carbonate; Mania

躁狂症是指患者受遗传、孤僻性格、神经敏感、生活环境等因素的影响而出现的情绪亢奋、言语增多、反应过激等一系列症状的精神科常见疾病[1-2]。本研究观察了丙戊酸镁联合氯硝西泮治疗躁狂症的疗效，现报告如下。

1资料与方法

1.1资料来源

选取齐齐哈尔市精神卫生中心(以下简称“我院”)2013年9月—2014年9月收治的70例躁狂症患者，按随机数字表法分为观察组38例和对照组32例。观察组患者中，男性22例，女性16例，年龄21～57岁，平均年龄(34.1±7.8)岁；病程……