| 王利峰,马丽,孔建国,刘霞.奥氮平联合丙戊酸钠治疗颅脑外伤后躁狂状态的疗效及对认知功能的影响[J].济宁医学院学报,2026,49(5):430-435 |
| 奥氮平联合丙戊酸钠治疗颅脑外伤后躁狂状态的疗效及对认知功能的影响 |
| Efficacy of olanzapine combined with sodium valproate in the treatment of manic states after traumatic brain injury and its effect on cognitive function |
| 投稿时间：2026-03-17 |
| DOI：10.3969/j.issn.1000-9760.2026.05.008 |
| 中文关键词: 颅脑外伤 躁狂状态 奥氮平 丙戊酸钠 认知功能 药物联合治疗 |
| 英文关键词: Traumatic brain injury Manic state Olanzapine Sodium valproate Cognition Combination drug therapy |
| 基金项目:济宁市重点研发计划项目(2023YXNS141) |
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| 中文摘要: |
| 目的 探讨奥氮平联合丙戊酸钠治疗颅脑外伤（TBI）后躁狂状态的临床疗效及其对认知功能的影响。方法 纳入2023年10月—2025年12月因 TBI 住院并出现躁狂症状的患者100例，按治疗方案分为单药组和联合组（各50例）。分别于基线期、第1周、第2周、第4周、第8周采用贝克-拉范森躁狂量表（BRMS）评估躁狂症状，采用蒙特利尔认知评估量表（MoCA）评估认知功能，并用副反应量表（Treatment Emergent Symptom Scale，TESS）评估基线期不良反应。结果 两组基线 BRMS、MoCA和TESS评分比较差异无统计学意义。治疗第8周，联合组BRMS评分2.00（0.00，5.00）分，低于单药组6.50（4.00，9.00）分（P＜0.001）；联合组MoCA评分26.50（26.00，28.00）分，高于单药组26.00（26.00，27.00）分（P=0.012）。广义估计方程分析显示，BRMS和MoCA评分均存在显著时间×组别交互效应（Wald χ2=20.308、29.399，P＜0.001）。结论 奥氮平联合丙戊酸钠治疗TBI后躁狂状态可更明显降低BRMS评分，并促进MoCA评分改善，提示联合治疗在缓解躁狂症状及改善认知功能方面具有一定潜在优势。但本研究样本量较小、随访时间较短，且未对治疗期间不良反应进行动态评价，相关结论仍需进一步验证。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of olanzapine combined with sodium valproate in the treatment of manic episodes after traumatic brain injury (TBI) and its effects on cognitive function.Methods A total of 100 hospitalized patients who developed manic symptoms after TBI between October 2023 and December 2025 were included.According to the treatment regimen,they were divided into a monotherapy group and a combination group,with 50 patients in each group.Manic symptoms were assessed using the Bech-Rafaelsen Mania Rating Scale (BRMS),and cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) at baseline and at weeks 1,2,4,and 8.Adverse effects was assessed at baseline using the Treatment Emergent Symptom Scale (TESS).Results There were no statistically significant differences in baseline BRMS,MoCA or TESS scores between the two groups.At week 8,the BRMS score in the combination group was lower than that in the monotherapy group [2.00(0.00,5.00) vs 6.50(4.00,9.00),P＜0.001],while the MoCA score was higher in the combination group than in the monotherapy group [26.50(26.00,28.00) vs 26.00(26.00,27.00),P=0.012].Generalized estimating equation analysis showed significant time-by-group interaction effects for both BRMS and MoCA scores (Wald χ2=20.308 and 29.399,respectively;both P＜0.001).Conclusion Olanzapine combined with sodium valproate was associated with greater improvements in BRMS and MoCA scores compared with olanzapine monotherapy in patients with post-TBI mania.However,these findings should be interpreted cautiously because of the small sample size,short follow-up,and lack of dynamic safety assessment. |
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