摘要
目的 探究奥卡西平和丙戊酸钠与碳酸锂治疗女性双相情感障碍躁狂发作患者的疗效及对内分泌功能的影响。方法 选取2020年3—9月于本院就诊的150例女性双相情感障碍躁狂发作患者作为研究对象,按照随机数字法分为奥卡西平组、丙戊酸钠组、碳酸锂组,每组50例,分别给予奥卡西平、丙戊酸钠与碳酸锂治疗。比较3组治疗前后贝克拉范森躁狂量表(BRMS)评分、不良反应发生情况、甲状腺功能及性激素水平。结果 治疗3、6、12个月,3组BRMS量表评分比较差异有统计学意义(P<0.05),奥卡西平组BRMS量表评分明显低于丙戊酸钠组与碳酸锂组(P<0.05)。治疗1、3、6、12个月,3组不良反应发生率比较差异无统计学意义。治疗1、3、6、12个月,奥卡西平组与丙戊酸钠组游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)水平,组内比较差异无统计学意义;治疗3、6、12个月,碳酸锂组FT_(3)及FT_(4)水平均低于治疗1个月,TSH水平高于治疗1个月,(P<0.05);治疗6、12个月,碳酸锂组FT_(3)及FT_(4)水平均低于治疗3个月,TSH水平高于治疗3个月(P<0.05);治疗12个月,碳酸锂组FT_(3)及FT_(4)水平均低于治疗6个月,TSH水平高于治疗6个月(P<0.05)。治疗1、3、6、12个月,3组催乳素(PRL)与雌二醇(E2)水平,组内比较差异无统计学意义;奥卡西平组、碳酸锂组的睾酮(T)水平,组内比较差异无统计学意义。治疗3、6、12个月,丙戊酸钠组T水平明显高于治疗1个月(P<0.05);治疗6、12个月,丙戊酸钠组T水平明显高于治疗3个月(P<0.05);治疗12个月,丙戊酸钠组T水平明显高于治疗6个月(P<0.05)。结论 奥卡西平、丙戊酸钠与碳酸锂药物的不良反应相当,奥卡西平治疗双相情感障碍临床疗效显著,无明显甲状腺功能与性激素水平改变,值得临床推广应用。
Objective To explore the efficacy of oxcarbazepine,sodium valproate and lithium carbonate in the treatment of bipolar manic episodes in female patients and its effects on endocrine function.Methods 150 female patients with bipolar manic episodes who were treated in our hospital from March to September 2020 were selected as the research subjects,and they were divided into oxcarbazepine group,sodium valproate group,and lithium carbonate group according to random number method,with 50 cases in each group,and were treated with oxcarbazepine,sodium valproate and lithium carbonate respectively.The Bech-Rafaelsen mania rating scale(BRMS) scores,adverse reactions,thyroid function and sex hormone levels were compared among the three groups before and after treatment.Results 3,6,12 months of treatment,there were significant differences in BRMS scale scores among the three groups(P<0.05),the BRMS score of oxcarbazepine group was significantly lower than that of sodium valproate group and lithium carbonate group(P<0.05).1,3,6,and 12 months of treatment,there was no significant difference in the incidence of adverse reactions among the three groups.1,3,6,and 12 months of treatment,there was no significant difference in the levels of free thyroxine(FT_(3)),free thyroxine(FT_(4)),and thyrotropin(TSH) between the oxcarbazepine group and the sodium valproate group;3,6 and 12 months of treatment,the levels of FT_(3)and FT_(4)in the lithium carbonate group were lower than those of 1 month of treatment,and the level of TSH was higher than that of 1month of treatment(P<0.05);6 and 12 months of treatment,the levels of FT_(3) and FT_(4) in the lithium carbonate group were lower than those of 3months of treatment,and the level of TSH was higher than that of 3 months of treatment(P<0.05);2 months of treatment,the levels of FT_(3)and FT_(4)in the lithium carbonate group were lower than those of 6 months of treatment,and the level of TSH was higher than that of 6 months of treatment(P<0.05).1,3,6,and 12 months of treatment,there was no significant difference in the levels of prolactin(PRL) and estradiol(E2) among the three groups;there was no significant difference in the testosterone(T) level between the oxcarbazepine group and the lithium carbonate group.3,6 and 12months of treatment,the T level in sodium valproate group was significantly higher than that in 1 month of treatment(P<0.05);6 and 12 months of treatment,the T level in the sodium valproate group was significantly higher than that in the 3-month treatment(P<0.05);12 months of treatment,the T level of sodium valproate group was significantly higher than that of 6 months of treatment(P<0.05).Conclusion The adverse reactions of oxcarbazepine,sodium valproate and lithium carbonate are comparable.Oxcarbazepine has significant clinical efficacy in the treatment of bipolar disorder without obvious changes in thyroid function and sex hormone levels,which is worthy of clinical application.
作者
杜育如
黄燕
郑秒玲
陈泽元
张理强
黄志敏
DU Yuru;HUANG Yan;ZHENG Miaoling;CHEN Zeyuan;ZHANG Liqiang;HUANG Zhimin(The Second Department of Psychiatry,The Third People’s Hospital of Zhanjiang,Zhanjiang,Guangdong,524000,China)
出处
《当代医学》
2022年第18期88-91,共4页
Contemporary Medicine
基金
湛江市科技计划项目(2020B01456)。
