富马酸喹硫平片联合碳酸锂缓释片对躁狂抑郁症治疗效果及认知功能的影响
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摘要
研究与探讨富马酸喹硫平片联合碳酸锂缓释片对躁狂抑郁症治疗效果及认知功能的影响,为临床研究提供参考依据。选取2015年1月—2017年1月重庆三峡中心医院平湖分院治疗的104例躁狂抑郁症患者予以研究,根据入院顺序的不同编号分为联合组和单独组,每组52例。单独组单独应用碳酸锂缓释片治疗,联合组在单独组的基础上联合应用富马酸喹硫平片予以治疗,对2组治疗效果及认知功能情况等研究结果进行对比。结果显示:2组研究对象治疗前的贝克-拉范森躁狂量表(BRMS)评分没有统计学差异(t=0.517,p>0.05);治疗后6周,2组较治疗前均有明显的改善(p<0.05),且联合组的BRMS评分明显低于单独组,差异具有统计学意义(t=3.674,p<0.05)。联合组的有效率为94.2%,明显高于对照组的84.6%,差异统计学意义显著(χ2=5.172,p<0.05)。治疗前2组在执行功能、持续注意水平及言语记忆学习能力3个方面均没有统计学差异(p>0.05);治疗后认知功能3个方面虽然都有所下降,但与治疗前比较只有持续注意水平具有统计学差异(p<0.05);组间对比,执行功能与言语记忆学习能力无统计学差异(p>0.05),持续注意水平比较具有差异性(p<0.05)。2组治疗前TNF-α、IL-1、IL-10水平比较无统计学差异(p>0.05);治疗后TNF-α与IL-1水平均明显低于治疗前(p<0.05),IL-10水平明显高于治疗前(p<0.05);对治疗后各相关炎性因子进行组间比较,联合组TNF-α和IL-1水平均明显低于单独组(p<0.05),联合组IL-10水平明显高于单独组,且差异具有统计学意义(p<0.05)。研究结果表明:富马酸喹硫平片联合碳酸锂缓释片应用于躁狂抑郁症中临床治疗效果显著,可改善部分认知功能和炎症反应,其应用有着重要的临床意义。
The effect of of Quetiapine Fumarate Tablets and Lithium Carbonate Extended Release Tablets on the treatment of manic depression and cognitive function were studied and discussed,which provided a reference basis for clinical research.The study was conducted on 104 selected patients with manic depression who were admitted in our hospital from January 2015 to January 2017.The subjects were divided into combined group and single group with 52 people each group as per patient ID made by admission sequence.The single group was treated just with Lithium Carbonate Extended Release Tablets and the combined group Lithium Carbonate Extended Release Tablets and Quetiapine Fumarate Tablets.The study results such as treatment effect and cognitive function were compared.Before the treatment,there was no statistical difference on BRMS grade of subjects(t=0.517,p>0.05);after 6 weeks of treatment,some improvement was obviously seen(p<0.05),and the BRMS grade of combined group was greatly lower than that of single group,which difference has statistical meaning(t=3.674,p<0.05).The efficiency of combined group was 94.2%,obviously higher than 84.6%the result of single group,which difference has important statistical meaning(χ2=5.172,p<0.05).No statistical difference between two groups was found on executive functions,level of sustained attention,and linguistic memory and learning ability before the treatment(p>0.05);though the number in the three aspects decreased after treatment,only the level of sustained attention greatly changed(p<0.05);comparing the both groups,the executive functions and linguistic memory and learning ability had no statistical difference(p>0.05),except for the sustained attention(p<0.05).Before the treatment,the levels of TNF-α,IL-1,and IL-10 of both groups had no statistical difference(p>0.05);after treatment,the levels of TNF-αand IL-1 largely decreased(p<0.05),and the level of IL-10 greatly increased(p<0.05);comparing the inflammatory factors of both groups,the levels of TNF-αand IL-1 of combined group were greatly lower than that of the single group(p<0.05),and the level of IL-10 of combined group was remarkably higher than that of the single group,which difference has statistical meaning(p<0.05).It can be concluded that the Quetiapine Fumarate Tablets and Lithium Carbonate Extended Release Tablets are very effective on the clinical treatment of manic depression,and can improve part of the cognitive functions and inflammatory reactions.This kind of application has clinical meaning.
The effect of of Quetiapine Fumarate Tablets and Lithium Carbonate Extended Release Tablets on the treatment of manic depression and cognitive function were studied and discussed,which provided a reference basis for clinical research.The study was conducted on 104 selected patients with manic depression who were admitted in our hospital from January 2015 to January 2017.The subjects were divided into combined group and single group with 52 people each group as per patient ID made by admission sequence.The single group was treated just with Lithium Carbonate Extended Release Tablets and the combined group Lithium Carbonate Extended Release Tablets and Quetiapine Fumarate Tablets.The study results such as treatment effect and cognitive function were compared.Before the treatment,there was no statistical difference on BRMS grade of subjects(t=0.517,p>0.05);after 6 weeks of treatment,some improvement was obviously seen(p<0.05),and the BRMS grade of combined group was greatly lower than that of single group,which difference has statistical meaning(t=3.674,p<0.05).The efficiency of combined group was 94.2%,obviously higher than 84.6%the result of single group,which difference has important statistical meaning(χ2=5.172,p<0.05).No statistical difference between two groups was found on executive functions,level of sustained attention,and linguistic memory and learning ability before the treatment(p>0.05);though the number in the three aspects decreased after treatment,only the level of sustained attention greatly changed(p<0.05);comparing the both groups,the executive functions and linguistic memory and learning ability had no statistical difference(p>0.05),except for the sustained attention(p<0.05).Before the treatment,the levels of TNF-α,IL-1,and IL-10 of both groups had no statistical difference(p>0.05);after treatment,the levels of TNF-αand IL-1 largely decreased(p<0.05),and the level of IL-10 greatly increased(p<0.05);comparing the inflammatory factors of both groups,the levels of TNF-αand IL-1 of combined group were greatly lower than that of the single group(p<0.05),and the level of IL-10 of combined group was remarkably higher than that of the single group,which difference has statistical meaning(p<0.05).It can be concluded that the Quetiapine Fumarate Tablets and Lithium Carbonate Extended Release Tablets are very effective on the clinical treatment of manic depression,and can improve part of the cognitive functions and inflammatory reactions.This kind of application has clinical meaning.
引文
[1]董娇,陈楠,王长虹,等.富马酸喹硫平片或丙戊酸镁缓释片联合碳酸锂治疗双相情感障碍躁狂发作的临床研究[J].国际精神病学杂志,2016,43(2):249-251,262.
[2]Rosana Mota,Marta Gazal,Bruna A Acosta,et al.Interleukin-1βis Associated with Depressive Episode in Major Depression but Not in Bipolar Disorder[J].Journal of Psychiatric Research,2013,47(12):2011-2014.
[3]戴云飞,肖泽萍.中国精神障碍分类与诊断标准第3版与国际疾病分类第10版的比较[J].临床精神医学杂志,2013,23(6):426-427.
[4]马云,毛佩贤,任艳萍,等.双相抑郁的药物治疗现状及新探索[J].中国神经精神疾病杂志,2012,38(9):568-571.
[5]Emre Bora,Simavi Vahip,Fisun Akdeniz.Sustained Attention Deficits in Manic and Euthymic Patients with Bipolar Disorder[J].Progress in Neuropsychopharmacology&Biological Psychiatry,2006,30(6):1097-1102.
[6]刘雪峰.富马酸喹硫平片与碳酸锂联合用药方案治疗双相情感障碍躁狂发作的临床研究[J].航空航天医学杂志,2017,28(1):57-60.
[7]蒋玉龙,吴志国,粟幼嵩,等.碳酸锂合并喹硫平治疗双相障碍抑郁发作的疗效和安全性研究[J].中国医药导报,2012,9(2):86-88.
[8]Faye Ryles,Thomas D Meyer,Jaime Adan-Manes,et al.ASystematic Review of the Frequency and Severity of Manic Symptoms Reported in Studies that Compare Phenomenology Across Children,Adolescents and Adults with Bipolar Disorders[J].International Journal of Bipolar Disorders,2017,5(1):1-11.
[9]童永号.喹硫平治疗双相情感障碍的临床效果[J].中国实用神经疾病杂志,2016,19(1):118-119.
[10]Bai Yamei,Su Tungping,Li Chengta,et al.Comparison of Pro-inflammatory Cytokines Among Patients with Bipolar Disorder and Unipolar Depression and Normal Controls[J].Bipolar Disorders,2015,17(3):269-277.
[11]余金鸣,李水洪,牛亚辉.双心境稳定剂联合喹硫平治疗双相情感障碍躁狂发作的效果[J].实用临床医学,2015,16(1):1-3,6.
[12]洪茂春.奎硫平与锂盐应用在双相情感障碍急性狂躁治疗中的疗效分析[J].临床医药文献电子杂志,2016,3(34):6833,6836.
[13]Bartholomeus(Benno)C M Haarman,Rixt F RiemersmaVan der Lek,Huibert Burger,et al.Relationship between Clinical Features and Inflammation-related Monocyte Gene Expression in Bipolar Disorder-towards a Better Understanding of Psychoimmunological Interactions[J].Bipolar Disorders,2014,16(2):137-150.
[14]马建英,杨勇.富马酸喹硫平片联合碳酸锂对双相情感障碍躁狂发作患者认知功能的影响[J].检验医学与临床,2018,15(2):195-197,201.
[15]赵敏.双相情感障碍与单相抑郁症患者之间的促炎细胞因子水平的比较分析[J].中国医学创新,2017,14(31):20-23.
[2]Rosana Mota,Marta Gazal,Bruna A Acosta,et al.Interleukin-1βis Associated with Depressive Episode in Major Depression but Not in Bipolar Disorder[J].Journal of Psychiatric Research,2013,47(12):2011-2014.
[3]戴云飞,肖泽萍.中国精神障碍分类与诊断标准第3版与国际疾病分类第10版的比较[J].临床精神医学杂志,2013,23(6):426-427.
[4]马云,毛佩贤,任艳萍,等.双相抑郁的药物治疗现状及新探索[J].中国神经精神疾病杂志,2012,38(9):568-571.
[5]Emre Bora,Simavi Vahip,Fisun Akdeniz.Sustained Attention Deficits in Manic and Euthymic Patients with Bipolar Disorder[J].Progress in Neuropsychopharmacology&Biological Psychiatry,2006,30(6):1097-1102.
[6]刘雪峰.富马酸喹硫平片与碳酸锂联合用药方案治疗双相情感障碍躁狂发作的临床研究[J].航空航天医学杂志,2017,28(1):57-60.
[7]蒋玉龙,吴志国,粟幼嵩,等.碳酸锂合并喹硫平治疗双相障碍抑郁发作的疗效和安全性研究[J].中国医药导报,2012,9(2):86-88.
[8]Faye Ryles,Thomas D Meyer,Jaime Adan-Manes,et al.ASystematic Review of the Frequency and Severity of Manic Symptoms Reported in Studies that Compare Phenomenology Across Children,Adolescents and Adults with Bipolar Disorders[J].International Journal of Bipolar Disorders,2017,5(1):1-11.
[9]童永号.喹硫平治疗双相情感障碍的临床效果[J].中国实用神经疾病杂志,2016,19(1):118-119.
[10]Bai Yamei,Su Tungping,Li Chengta,et al.Comparison of Pro-inflammatory Cytokines Among Patients with Bipolar Disorder and Unipolar Depression and Normal Controls[J].Bipolar Disorders,2015,17(3):269-277.
[11]余金鸣,李水洪,牛亚辉.双心境稳定剂联合喹硫平治疗双相情感障碍躁狂发作的效果[J].实用临床医学,2015,16(1):1-3,6.
[12]洪茂春.奎硫平与锂盐应用在双相情感障碍急性狂躁治疗中的疗效分析[J].临床医药文献电子杂志,2016,3(34):6833,6836.
[13]Bartholomeus(Benno)C M Haarman,Rixt F RiemersmaVan der Lek,Huibert Burger,et al.Relationship between Clinical Features and Inflammation-related Monocyte Gene Expression in Bipolar Disorder-towards a Better Understanding of Psychoimmunological Interactions[J].Bipolar Disorders,2014,16(2):137-150.
[14]马建英,杨勇.富马酸喹硫平片联合碳酸锂对双相情感障碍躁狂发作患者认知功能的影响[J].检验医学与临床,2018,15(2):195-197,201.
[15]赵敏.双相情感障碍与单相抑郁症患者之间的促炎细胞因子水平的比较分析[J].中国医学创新,2017,14(31):20-23.