| 80 | 6 | 61 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 探究阿立哌唑联合丙戊酸镁治疗双相情感障碍（BP）抑郁发作的疗效及其安全性。方法 选取2021年5月至2023年5月收治的BP抑郁发作病例90例作为研究对象，随机分为对照组45例（丙戊酸镁治疗）和观察组45例（丙戊酸镁+阿立哌唑治疗）。比较2组的治疗效果、汉密尔顿抑郁量表-17(HAMD-17)评分、脑源性神经营养因子水平、炎症因子水平和不良反应发生情况。结果观察组的临床总有效率（95.56%）高于对照组（62.22%），差异有统计学的意义（P<0.05）；治疗后2组HAMD-17评分均低于治疗前，并且观察组低于对照组（P <0.05）；治疗后2组白细胞介素-4、白细胞介素-10、脑源性神经营养因子、转化生长因子-β1水平均高于治疗前（P<0.05），并且观察组高于对照组（P<0.05）；白细胞介素-1和肿瘤坏死因子水平均低于治疗前（P<0.05），并且观察组低于对照组（P<0.05）。2组不良反应总发生率比较差异无统计学意义（P>0.05）。结论 阿立哌唑联合丙戊酸镁可以提高BP抑郁发作的疗效，改善患者抑郁状态，缓解炎症反应，改善免疫功能，调节神经生长因子水平，并且安全性较高，可以临床推广。
Abstract：AIM To investigate the efficacy and safety of aripiprazole combined with magnesium valproate in treating depressive episodes of bipolar disorder(BP). METHODS A total of 90 patients with depressive episodes of BP admitted from May 2021 to May 2023 were included in the study and further randomly divided into control group(45 patients, magnesium valproate extended-release tablets) and observation group(45 patients, magnesium valproate extended-release tablets combined with aripiprazole tablets). Treatment outcomes, Hamilton depression rating scale 17(HAMD-17) scores, brain-derived neurotrophic factor, serum inflammatory factors, and adverse reactions between 2 groups of patients were compared. RESULTS The overall clinical effective rate of the observed group(95.56%) was greater than the reference group(62.22%), with a significant difference(P<0.05). HAMD-17 scores of both groups of patients decreased, and the observation group was lower than the control group after treatment(P<0.05). Levels of interleukin-4,interleukin-10, brain-derived neurotrophic factor, and transforming growth factor β1 were significantly increased in both groups of patients, and the observation group was higher than the control group. While levels of interleukin-1 and tumor necrosis factor were significantly decreased, and the observation group was better than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSION Aripiprazole combined with magnesium valproate could enhance treatment outcomes for bipolar depression, alleviate depressive symptoms, reduce inflammation, bolster immune function, and modulate nerve growth factor levels, with a good safety profile. The combination regimen is worthy of clinical promotion.
[1] BONNíN C D M, REINARES M, MARTíNEZ-ARíN A, et al.Improving functioning, quality of life, and well-being in patients with bipolar disorder[J]. Int J Neuropsychopharmacol, 2019,22(8):467.
[2] HUBER R S, DOUGLAS K M, SPERRY S H, et al. The Early MidCareer Committee(EMCC)of the International Society for Bipolar Disorders:aspirations and goals[J]. Bipolar Disord, 2022, 24(8):781.
[3] CICHO?L, JANAS-KOZIK M, SIWIEC A, et al. Clinical picture and treatment of bipolar affective disorder in children and adolescents[J]. Psychiatr Pol, 2020, 54(1):35.
[4] MADIREDDY S, MADIREDDY S. Therapeutic interventions to mitigate mitochondrial dysfunction and oxidative stress-induced damage in patients with bipolar disorder[J]. Int J Mol Sci, 2022,23(3):1844.
[5] PATINO L R, KLEIN C C, STRAWN J R, et al. A randomized,double-blind, controlled trial of lithium versus quetiapine for the treatment of acute mania in youth with early course bipolar disorder[J]. J Child Adolesc Psychopharmacol, 2021, 31(7):485.
[6] MOON W, JI E, SHIN J, et al. Effect of valproate and lithium on dementia onset risk in bipolar disorder patients[J]. Sci Rep,2022, 12(1):14142.
[7]刘晨霞,朱利利.中药汤剂联合阿立哌唑治疗慢性精神分裂症的疗效观察[J].实用临床医药杂志, 2019, 23(17):119.
[8] YATHAM LAKSHMI N, KENNEDY SIDNEY H, PARIKH SAGAR V, et al. Canadian Network for Mood and Anxiety Treatments(CANMAT)and International Society for Bipolar Disorders(ISBD)2018 guidelines for the management of patients with bipolar disorder[J]. Bipolar Disord, 2018, 20(2):97.
[9]王晓慧,孙家华.现代精神医学[M].北京:人民军医出版社,2002:163-166.
[10]李芳菲,叶静华,何志翔,等. PHQ-9、PHQ-15和HAMD-17在类风湿关节炎患者中评估抑郁障碍的相关性[J].解剖学研究,2020, 42(1):76.
[11] HARRISON P J, GEDDES J R, TUNBRIDGE E M. The emerging neurobiology of bipolar disorder[J]. Trends Neurosci, 2018,41(1):18.
[12] WEINSTEIN S M, CRUZ R A, ISAIA A R, et al. Child-and family-focused cognitive behavioral therapy for pediatric bipolar disorder:applications for suicide prevention[J]. Suicide Life Threat Behav, 2018, 48(6):797.
[13] KATZ I R, ROGERS M P, LEW R, et al. Lithium treatment in the prevention of repeat suicide-related outcomes in veterans with major depression or bipolar disorder:a randomized clinical trial[J].JAMA Psychiatry, 2022, 79(1):24.
[14]陈爱群,陈元林,蔡美香.碳酸锂联合阿立哌唑治疗双向情感障碍的效果[J].医学理论与实践, 2022, 35(14):2397.
[15]李宏斌,钟远惠,李祎鋆.富马酸喹硫平联合丙戊酸镁治疗双相情感障碍患者临床效果[J].黑龙江医药, 2022, 35(2):387.
[16] YATHAM L N, ARUMUGHAM S S, KESAVAN M, et al. Duration of adjunctive antidepressant maintenance in bipolar I depression[J]. N Engl J Med, 2023, 389(5):430.
[17]许晴丽,成加林.富马酸喹硫平片联合丙戊酸镁缓释片治疗双相障碍抑郁发作的疗效观察[J].现代消化及介入诊疗, 2019,24(A2):1406.
[18] ROMOLI M, MAZZOCCHETTI P, D’ALONZO R, et al. Valproic acid and epilepsy:from molecular mechanisms to clinical evidences[J]. Curr Neuropharmacol, 2019, 17(10):926.
[19]许珍,高成,邹峰.阿立哌唑联合阿戈美拉汀对抑郁症患者抑郁情绪、睡眠质量及神经递质指标的影响[J].徐州医科大学学报,2022, 42(2):123.
[20]骆明杰,陆承鹏.枣仁安神胶囊联合阿立哌唑对精神分裂症患者血清神经递质、认知功能、生活质量的影响[J].现代药物与临床,2021, 36(7):1471.
基本信息:
DOI：10.19577/j.1007-4406.2024.09.008
中图分类号:R749.4
引用信息:
[1]薛林峰,曹满占,张宇.阿立哌唑联合丙戊酸镁对双相情感障碍抑郁发作的疗效及安全性分析[J].中国临床药学杂志,2024,33(09):682-686.DOI:10.19577/j.1007-4406.2024.09.008.
基金信息:
河北省2023年度医学科学研究课题计划（编号20232191）
2024-09-25
2024-09-25