足量丙戊酸钠合并利培酮治疗急性躁狂症的疗效分析

郝志君

[摘要] 目的 探讨足量丙戊酸钠合并利培酮治疗急性躁狂症的疗效。 方法 选取2019年4月至2020年5月本院收治的60例急性躁狂症患者纳入本研究，采用随机数字表法分组，每组各30例。观察组给予足量丙戊酸钠+利培酮，对照组采用小剂量丙戊酸钠+利培酮，对比两组患者的临床疗效、躁狂量表（BRMS）评分、阳性和阴性症状（PANSS）评分、炎症因子及不良反应发生情况。 结果 观察组临床治疗总有效率为93.33%，高于对照组的66.67%，差异有统计学意义（P<0.05）;治疗1、2、4周时，观察组的BRMS评分、PANSS评分均明显低于对照组，差异均有统计学意义（P<0.05）;观察组治疗后的腫瘤坏死因子-α（TNF-α）、白介素-4（IL-4）水平分别为（16.52±1.47）pg/mL、（74.26±5.28）ng/mL，均低于对照组的（21.24±2.25）pg/mL、（88.45±6.95）ng/mL，差异均有统计学意义（P<0.05）;观察组不良反应总发生率为20.00%，略高于对照组的16.67%，但差异无统计学意义（P>0.05）。 结论 给予急性躁狂症患者足量丙戊酸钠+利培酮进行治疗，可改善患者躁狂病情，提高临床疗效，降低炎症因子水平。足量丙戊酸钠并未增加患者不良反应发生率，说明此联合用药方案安全性高。

[关键词] 急性躁狂症;丙戊酸钠;利培酮;用药剂量;躁狂量表评分;炎症因子

[中图分类号] R749.4          [文献标识码] B          [文章编号] 1673-9701（2021）31-0123-04

[Abstract] Objective To investigate the efficacy of sufficient sodium valproate combined with risperidone in the treatment of acute mania. Methods Sixty patients with acute mania admitted to our hospital from April 2019 to May 2020 were selected for this study. They were grouped by a random number table，with 30 cases in each group. The observation group was given sufficient sodium valproate+risperidone. The control group was given low-dose sodium valproate + risperidone. The clinical efficacy， mania scale（BRMS） score， positive and negative symptoms （PANSS） score， inflammatory factors， and adverse reactions between the two groups were compared. Results The total effective rate of clinical treatment in the observation group was 93.33%， which was higher than that of 66.67% in the control group，with significant difference（P<0.05）. The BRMS and PANSS scores in the observation group were significantly lower than those in the control group at 1，2，and 4 weeks of treatment. The differences between the two groups were statistically significant （P<0.05）. The tumor necrosis factor-α （TNF-α） and interleukin-4 （IL-4） levels in the observation group after treatment were （16.52±1.47） pg/mL， （74.26±5.28） ng/mL， which were both lower than those of [（21.24±2.25） pg/mL， （88.45±6.95） ng/mL] in the control group（P<0.05）. The total incidence of adverse reactions in the observation group was 20.00%，which was slightly higher than that of 16.67% in the control group. But the difference was not statistically significant（P>0.05）. Conclusion The treatment of sufficient sodium valproate and risperidone in patients with acute mania can improve the patient's manic condition， improve clinical efficacy， and reduce the level of inflammatory factors. Sufficient sodium valproate does not increase the incidence of adverse reactions in patients， indicating that this combination regimen is highly safe.

[Key words] Acute mania; Sodium valproate; Risperidone; Dosage; Mania rating scale score; Inflammatory factors

临床研究表明，急性躁症与遗传因素有密切关系，同时中枢反应及患者自身体质因素，也是重要的发病原因[1]。在发病时，患者短时间内出现情绪失控、思想跳跃、胡言乱语等症状，如果不予以控制则上述症状会频繁发生。急性躁狂症患者具有暴力及攻击性强的表现，未能及时帮助患者采取有效的治疗时，将严重危害社会治安，形成潜在风险，造成患者家属的惶恐心理，同時对患者自身安全也有较大威胁。……