躁狂症中西医结合的替代治疗：与两种西药联合治疗临床对照研究的循证医学评价
Replacement Treatment of Integration of Traditional Chinese Medicine and West Medicine for Mania: Evidence-Based Medicine Analysis of Clinical Control Study Compared to Combination of Two West Drugs
DOI: 10.12677/TCM.2018.76065, PDF,   
作者: 孙峰俐：浙江省立同德医院精神科，浙江省精神卫生中心，浙江 杭州；金 锐：浙江省立同德医院药剂科，浙江 杭州；朱建峰：浙江中医药大学，浙江 杭州；金卫东：浙江省立同德医院精神科，浙江省精神卫生中心，浙江 杭州；浙江中医药大学，浙江 杭州
关键词: 躁狂症；中药；心境稳定剂；抗精神病药物；Meta分析；Mania； Traditional Chinese Mediation； Mood Stabilizers； Antipsychotics； Meta-Analysis
摘要: 目的：评价中、西医治疗躁狂症对照研究的差异。方法：应用循证医学方法对符合纳入标准的5项研究进行分析，评价中西医结合治疗躁狂症与两种西药联合治疗对照研究的抑郁症状学、有效率的差异。结果：中西医结合治疗组症状学评分显著低于西药联合组(Z = 5.00, P < 0.00001，加权均数差 = 2.04, 95%可信区间为1.24~2.84)，但是有效率与西药联合组相比疗效相当，差异不显著(77.19% vs 71.93%, Z = 1.14, P = 0.25，比值比 = 1.33, 95%可信区间为0.81~2.17)。结论：中药能减轻躁狂症状，中西医结合与两种西药联合治疗躁狂症疗效相近,可以替代目前的西药联合治疗。
Abstract: Object: To assess the difference in efficacy for mania between Chinese medication group and west medication. Methods: The depressive symptoms and effective rate between Chinese medication and west medication that meet our criteria were assessed by evidence-based medicine. Results: The depressive symptoms of patients treated by Chinese medication was lower significantly than that of west medication (Z = 5.00, P < 0.00001). And no difference on effective rate between two groups was found (Z = 1.14, P = 0.25). Conclusion: Traditional Chinese medication can decrease manic symptoms and integration of traditional Chinese medicine west medicine is similar west drugs combination in therapy for mania and can replace the west drugs combination.
文章引用：孙峰俐, 金锐, 朱建峰, 金卫东. 躁狂症中西医结合的替代治疗：与两种西药联合治疗临床对照研究的循证医学评价[J]. 中医学, 2018, 7(6): 391-395. https://doi.org/10.12677/TCM.2018.76065

参考文献

[1] Yildiz, A., Vieta, E., Leucht, S. and Baldessarini, R.J. (2011) Efficacy of Antimanic Treatments: Meta-Analysis of Randomized, Controlled Trials. Neuropsychopharmacology, 36, 375-389. [Google Scholar] [CrossRef] [PubMed]
[2] Goldberg, J.F. (2017) That Which We Call a Mood Stabilizer: What’s in a Name? Australian & New Zealand Journal of Psychiatry. [Google Scholar] [CrossRef] [PubMed]
[3] Quartini, A., Iannitelli, A. and Bersani, G. (2016) Lithium: From Mood Stabilizer to Putative Cognitive Enhancer. Neural Regeneration Research, 11, 1234-1235. [Google Scholar] [CrossRef] [PubMed]
[4] 金卫东, 郭田生, 苗国栋, 等. 丙戊酸镁缓释剂治疗双相障碍临床应用的专家共识[J]. 临床精神医学杂志, 2012, 22(5): 282-292.
[5] 金卫东, 马永春, 任志斌. 丙戊酸镁与碳酸锂治疗躁狂发作对照研究的循证医学评价[J]. 精神医学杂志, 2010, 23(1): 1-3.
[6] Mitchell, P.B., Malhi, G. and Redwood, B.L. (2009) Summary of Guideline for Treatment of Bipolar Disorder. Australasian Psychiatry, 11, 39-53. [Google Scholar] [CrossRef] 
[7] 丁国安, 余国汉. 中西医结合治疗躁狂症36例疗效观察[J]. 中国民政医学杂志, 2001, 13(4): 229-230.
[8] 刘淑莲, 樊立凤, 齐志田. 清心抗狂汤治疗躁狂发作临床研究[J]. 山东中医杂志, 2003: 15-16.
[9] 梁小赤, 朱克武, 张乃玄. 中西医结合治疗躁狂症40例疗效观察[J]. 新中医, 2005, 37(2): 50-51.
[10] 吴玉红, 王松龄. 中西医结合治疗躁狂症的疗效观察[J]. 光明中医, 2012, 27(5): 975-976.
[11] 张泉成. 铁落定惊丸结合针刺治疗躁狂症临床疗效观察[J]. 湖北中医杂志, 2014, 36(6): 31-32.
[12] Yatham, L. and Milev, R. (2017) Guidelines For Treatment of Bipolar Disorder—Which One Should I Follow? Bipolar Disorder, 19, 18-19.
[13] 金锐, 沈莹, 朱建峰, 等. 奥卡西平与碳酸锂治疗躁狂症研究: 国内文献的Meta分析[J]. 神经疾病与精神卫生, 2017, 10(10): 739-742.
[14] 贾建真, 王凌立, 王恩长, 等. 生铁落饮加味配合西药治疗躁狂疗效观察[J]. 陕西中医, 2014, 35(10): 1381-1382.
[15] 杨祺昕. 改良大承气汤治疗躁狂症的临床疗效[J]. 内蒙古中医药, 2015, 34(8): 19.