中国临床药理学杂志

喹硫平联合碳酸锂治疗双相情感障碍的临床研究

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陆艺 ^a , 米国琳 ^b , 王玮 ^a , 简佳 ^c , 李芳华 ^d , 张立超 ^a , 路淑淑 ^e

中国临床药理学杂志 | 临床与基础桥接研究 2025,41(23): 3328-3334

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中国临床药理学杂志 |临床与基础桥接研究 2025 , 41 (23) : 3328 -3334

喹硫平联合碳酸锂治疗双相情感障碍的临床研究

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陆艺^a, 米国琳^b, 王玮^a, 简佳^c, 李芳华^d, 张立超^a, 路淑淑^e

作者信息

^a.山东省精神卫生中心/山东大学附属精神卫生中心物理治疗科，山东济南 250014

^b.山东省精神卫生中心/山东大学附属精神卫生中心心身医学科，山东济南 250014

^c.山东省精神卫生中心/山东大学附属精神卫生中心精神六科，山东济南 250014

^d.山东省精神卫生中心/山东大学附属精神卫生中心临床心理一科，山东济南 250014

^e.山东省精神卫生中心/山东大学附属精神卫生中心药学部，山东济南 250014

通讯作者:

陆艺 MP: 1870537073 E-mail: luyibabyflower@126.com

作者简介:

陆艺（1977-），女，主任医师，主要从事精神卫生、心身医学与睡眠障碍的中西医结合及物理治疗专业方向的临床工作与研究

Clinical trial on the combination of quetiapine and lithium carbonate for treating bipolar disorder

Yi LU^a, Guo-lin MI^b, Wei WANG^a, Jia JIAN^c, Fang-hua LI^d, Li-chao ZHANG^a, Shu-shu LU^e

Affiliations

^a.Department of Physical Therapy, Shandong Mental Health Center/Mental Health Center Affiliated to Shandong University, Jinan 250014, Shandong Province, China

^b.Department of Psychosomatic Medicine, Shandong Mental Health Center/Mental Health Center Affiliated to Shandong University, Jinan 250014, Shandong Province, China

^c.Department of Psychiatry 6, Shandong Mental Health Center/Mental Health Center Affiliated to Shandong University, Jinan 250014, Shandong Province, China

^d.Department of Clinical Psychology 1 Department, Shandong Mental Health Center/Mental Health Center Affiliated to Shandong University, Jinan 250014, Shandong Province, China

^e.Department of Pharmacy, Shandong Mental Health Center/Mental Health Center Affiliated to Shandong University, Jinan 250014, Shandong Province, China

出版时间: 2025-12-17 doi: 10.13699/j.cnki.1001-6821.2025.23.005

文章导航

摘要

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目的

观察喹硫平片联合碳酸锂片和无抽搐电休克疗法（MECT）治疗双相情感障碍的临床疗效及安全性。

方法

将双相情感障碍患者分为对照组与试验组，2组均行常规治疗。对照组在常规治疗基础上实施MECT，每周给予3次治疗，隔天1次，共治疗12次。治疗期间口服碳酸锂缓释片，初始剂量0.25 g·d^-1，分1~2次服用，每周检测血锂浓度，维持0.8~1.2 mmol·L^-1，共用药6周。试验组在对照组基础上餐后口服富马酸喹硫平片，前4 d日总剂量分别为50、100、20、300 mg，分2次服用，第4 d后逐渐增加剂量至300~450 mg·d^-1，根据患者的临床反应和耐受性调整剂量，控制摄入150~750 mg·d^-1，共用药6周。比较2组的临床疗效、血清学检测、抑郁和躁狂程度、认知能力和社会功能，并进行安全性评价。

结果

本研究共筛选136例，其中22例不符合入排标准，114例纳入研究，试验组和对照组各57例，其中对照组有6例因个人原因和失访脱落，试验组有2例因药物不良反应和失访脱落，最终对照组和试验组分别纳入51和55例。治疗6周后，对照组和试验组的总有效率分别为72.55%（37例/51例）和89.09%（49例/55例）；促甲状腺激素（TSH）分别为（2.72±0.42）和（2.90±0.44）μIU·mL^-1；泌乳素（PR）分别为（13.58±2.40）和（15.27±2.56）ng·mL^-1；汉密尔顿抑郁量表（HAMD）-17评分分别为（9.53±1.79）和（8.76±1.67）分；倍克-拉范森躁狂量表（BRMS）评分分别为（7.04±1.39）和（6.47±1.35）分；霍普金斯词语学习测验（HVLT-R）评分分别为（26.94±4.85）和（29.76±3.81）分；持续操作测验（CPT）评分分别为（0.79±0.12）和（0.84±0.10）分；社会功能缺陷筛选量表（SDSS）评分分别为（6.92±1.18）和（6.38±0.99）分。试验组上述指标与对照组比较，在统计学上差异均有统计学意义（均P<0.05）。治疗期间，试验组的主要药物不良反应为困倦、口干、头晕、体位性低血压，对照组为恶心、困倦、口干、便秘。对照组和试验组药物不良反应总发生率分别为11.76%（6例/51例）和7.27%（4例/55例），在统计学上差异无统计学意义（P>0.05）。

结论

喹硫平片联合碳酸锂片和MECT较仅应用碳酸锂片和MECT治疗双相情感障碍效用更佳，且安全性良好。

关键词

喹硫平片 / 碳酸锂片 / 无抽搐电休克疗法 / 双相情感障碍 / 临床研究

Abstract

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Objective

To observe the clinical efficacy and safety of quilu tablets combined with lithium carbonate tablets and modified electroconvulsive therapy (MECT) in the treatment of bipolar disorder.

Methods

Patients with bipolar disorder were divided into control group and treatment group, both receiving routine treatment. The control group received MECT in addition to conventional treatment, with 3 sessions per week, administered every other day, totaling 12 treatments. During the treatment period, the patient was prescribed sustained-release lithium carbonate tablets with an initial dose of 0.25 g·d^-1, administered in 1-2 divided doses. Serum lithium levels were monitored weekly, maintained within the therapeutic range of 0.8-1.2 mmol·L^-1, and the medication was continued for a total of 6 weeks. The treatment group took quetiapine fumarate tablets orally after meals based on control group. The total doses for the first 4 days were 50, 100, 20 and 300 mg, respectively, taken in 2 doses. After the 4th day, the dose gradually increased to 300-450 mg·d^-1, and the dose was adjusted according to the patient’s clinical response and tolerance. The intake was controlled at 150-750 mg·d^-1, and the medication was shared for 6 weeks. Clinical efficacy, serological testing, depression and mania severity, cognitive ability, social function and occurrence of adverse drug reactions were compared between the two groups.

Results

A total of 136 cases were screened in this study. Among them, 22 did not meet the inclusion and exclusion criteria, leaving 114 eligible for the study. They were divided into treatment group and control group, each comprising 57 cases. Six cases in control group were excluded due to personal reasons and loss to follow-up, while two cases in treatment group were excluded due to adverse drug reactions and loss to follow-up. Ultimately, 51 and 55 cases were included in control and treatment groups, respectively. After 6 weeks of treatment, the overall response rates were 72.55% (37 cases/51 cases) and 89.09% (49 cases /55 cases) in control and treatment groups; thyroid-stimulating hormone (TSH) levels were (2.72±0.42) and (2.90±0.44) μIU·mL^-1, respectively; prolactin (PR) levels were (13.58±2.40) and (15.27±2.56) ng·mL^-1, respectively; Hamilton depression scale -17 (HAMD-17) scores were (9.53±1.79) and (8.76±1.67) score, respectively; Bech - Rafaelsen mania rating scale (BRMS) scores were (7.04±1.39) and (6.47±1.35) score, respectively; Hopkins verbal learning test-revised (HVLT-R) scores were (26.94±4.85) and (29.76±3.81) score, respectively; continuous performance test (CPT) scores were (0.79±0.12) and (0.84±0.10) score, respectively; and social dysfunction screening scale (SDSS) scores were (6.92±1.18) and (6.38±0.99) score, respectively. All these indicators in treatment group showed statistically significant differences compared to control group (all P<0.05). During treatment, the main adverse drug reactions in treatment group were drowsiness, dry mouth, dizziness and orthostatic hypotension; while those in control group were nausea, drowsiness, dry mouth and constipation. The overall incidence of adverse drug reactions were 11.76% (6 cases/51 cases) and 7.27% (4 cases /55 cases) in control and treatment groups, respectively, with no statistically significant difference (P>0.05).

Conclusion

Quetiapine tablets combined with lithium carbonate tablets and MECT are more effective than using only lithium carbonate tablets and MECT in treating bipolar disorder, and the safety is good.

Key words

quetiapine tablet / lithium carbonate tablet / modified electroconvulsive therapy / bipolar disorder / clinical research

引用本文

陆艺, 米国琳, 王玮, 简佳, 李芳华, 张立超, 路淑淑. 喹硫平联合碳酸锂治疗双相情感障碍的临床研究. 中国临床药理学杂志, 2025 , 41 (23) : 3328 -3334 . DOI: 10.13699/j.cnki.1001-6821.2025.23.005

Yi LU, Guo-lin MI, Wei WANG, Jia JIAN, Fang-hua LI, Li-chao ZHANG, Shu-shu LU. Clinical trial on the combination of quetiapine and lithium carbonate for treating bipolar disorder[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (23) : 3328 -3334 . DOI: 10.13699/j.cnki.1001-6821.2025.23.005

基金

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中国严重精神障碍无抽搐电休克治疗的应用现况及认知损害的全国多中心队列研究(KN-2022-133)

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2025年第41卷第23期

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文章信息

doi: 10.13699/j.cnki.1001-6821.2025.23.005

接收时间：2025-05-13
首发时间：2026-08-05
出版时间：2025-12-17

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收稿日期：2025-05-13

基金

中国严重精神障碍无抽搐电休克治疗的应用现况及认知损害的全国多中心队列研究(KN-2022-133)

作者信息

^a.山东省精神卫生中心/山东大学附属精神卫生中心物理治疗科，山东济南 250014

^b.山东省精神卫生中心/山东大学附属精神卫生中心心身医学科，山东济南 250014

^c.山东省精神卫生中心/山东大学附属精神卫生中心精神六科，山东济南 250014

^d.山东省精神卫生中心/山东大学附属精神卫生中心临床心理一科，山东济南 250014

^e.山东省精神卫生中心/山东大学附属精神卫生中心药学部，山东济南 250014

通讯作者:

陆艺 MP: 1870537073 E-mail: luyibabyflower@126.com

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
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