首页|期刊导航|临床与病理杂志|丙戊酸钠联合奥氮平治疗脑器质性精神障碍的疗效

丙戊酸钠联合奥氮平治疗脑器质性精神障碍的疗效OA

Efficacy of sodium valproate combined with olanzapine in the treatment of organic mental disorders

中文摘要英文摘要

目的:脑器质性精神障碍是由脑部结构或功能异常引发的精神紊乱综合征,严重影响患者生活质量,加重社会负担,且随年龄增长发病率呈显著上升趋势.该病病因复杂,单一药物治疗疗效欠佳,亟需探索安全有效的联合用药方案.因此,本研究探讨丙戊酸钠与奥氮平的联合疗法对脑器质性精神障碍患者的临床疗效及安全性.方法:回顾性选取2023年1月至2024年12月山东省戴庄医院老年精神科收治的184例脑器质性精神障碍患者作为研究对象,根据用药情况分为观察组(n=82)和对照组(n=102),观察组采用丙戊酸钠联合奥氮平治疗,对照组采用奥氮平治疗.比较2组的治疗总有效率、简明精神评定量表(Brief Psychiatric Rating Scale,BPRS)评分及不良反应,并进一步分析影响观察组疗效的相关因素.结果:2组治疗第2周总有效率均高于本组治疗第1周(均P<0.05).2组治疗第1周总有效率的差异无统计学意义(P>0.05);观察组治疗第2周总有效率高于同期对照组(P<0.05).2组患者BPRS评分随着治疗时间的延长呈下降趋势(P<0.05),重复测量因素方差分析显示,观察组BPRS评分低于对照组(P<0.05),具体体现在观察组BPRS中的缺乏活力、敌对猜疑症状因子评分低于对照组(均P<0.05).观察组疗效的单因素分析未发现显著相关的影响因素.治疗第2周2组不良反应发生率及治疗中出现症状量表(Treatment Emergent Symptom Scale,TESS)评分比较,差异均无统计学意义(均P>0.05).结论:丙戊酸钠联合奥氮平能提高脑器质性精神障碍患者治疗有效率,改善患者精神症状且不增加安全风险.

Objective:Organic mental disorders are syndromes of psychiatric disturbances caused by structural or functional abnormalities of the brain.They seriously affect patients'quality of life,increase the social burden,and show a significantly rising incidence with advancing age.Due to the complex etiology of this condition,monotherapy often yields unsatisfactory outcomes,and there is an urgent need to explore safe and effective combination therapies.Therefore,this study aims to investigate the clinical efficacy and safety of sodium valproate combined with olanzapine in patients with organic mental disorders. Methods:A total of 184 patients with organic mental disorders admitted to the Department of Mental Disorders Complicated with Physical Diseases of Shandong Daizhuang Hospital from January 2023 to December 2024 were retrospectively selected.According to medication regimens,patients were divided into an observation group(n=82)and a control group(n=102).The observation group received sodium valproate combined with olanzapine,while the control group received olanzapine alone.The total effective rate,Brief Psychiatric Rating Scale(BPRS)scores,and adverse reactions were compared between the 2 groups.Furthermore,factors influencing treatment efficacy in the observation group were further analyzed. Results:In both groups,the total effective rate at week 2 was higher than that at week 1(P<0.05).There was no significant difference in the total effective rate between the 2 groups at week 1(P>0.05);however,at week 2,the total effective rate in the observation group was higher than that in the control group(P<0.05).BPRS scores in both groups showed a decreasing trend over time(P<0.05).Repeated measures analysis of variance indicated that BPRS scores in the observation group were lower than those in the control group(P<0.05),specifically reflected in lower scores for the lack of vitality and hostility-suspicion symptom factors in the observation group(both P<0.05).Univariate analysis of the observation group did not identify any significant factors associated with treatment efficacy.At week 2,there were no statistically significant differences between the 2 groups in the incidence of adverse reactions or Treatment Emergent Symptom Scale(TESS)scores(P>0.05). Conclusion:Sodium valproate combined with olanzapine can improve the treatment efficacy in patients with organic mental disorders,alleviate psychiatric symptoms,and does not increase safety risks.

邵慧;牛文渊;赵正娟;鹿耕

山东省戴庄医院精神障碍合并躯体疾病科,济宁 272051山东省戴庄医院精神障碍合并躯体疾病科,济宁 272051威海市中心医院皮肤科,威海 264400鱼台县人民医院临床药学科,济宁 272300

医药卫生

丙戊酸钠奥氮平脑器质性精神障碍治疗效果不良反应

sodium valproateolanzapineorganic mental disorderstreatment efficacyadverse reactions

《临床与病理杂志》 2026 (1)

81-88,8

济宁市重点研发计划(2024YXNS209).This work was supported by the Jining Key Research and Development Program,China(2024YXNS209).

10.11817/j.issn.2095-6959.2026.250860

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