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Objective:To study the clinical effects of QingxinWendan decoction in the treatment of bipolar disorder (BD) manic episode.Methods:60 patients with BD manic episode treated in Hunan Brain Hospital from February 2020 to December 2020 were prospectively selected. They were included in the control group and the observation group according to the random alphabet method, with 30 cases in each group. The control group was treated with magnesium valproate sustained-release tablets, and the observation group was treated with Qingxin Wendan decoction combined with magnesium valproate sustained-release tablets. The curative effect was evaluated after 4 weeks of continuous treatment. The degree of mania before and after treatment was evaluated by Beck-Rafaelsen mania scale (BRMS); the cognitive function before and after treatment was evaluated by Wechsler Adult Intelligence Scale (WAIS-RC) and Wechsler Memory Scale (WMS); The levels of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), neuron specific enolase (NSE) and amyloid β protein (Aβ) levels were measured by enzyme linked immunosorbent assay (ELISA) before and after treatment. Spearman correlation analysis was used to analyze the correlation between serum NSE and Aβ levels and WAIS-RC and WMS scores in the two groups.Results:The curative effect of the observation group was better than that of the control group, with statistically significant difference ( P<0.05). After treatment, the BRMS scores of the control group and the observation group decreased (all P<0.05), and the BRMS scores of the observation group were lower than those of the control group ( P<0.05); After treatment, the WAIS-RC and WMS scores of the control group and the observation group increased (all P<0.05), and the WAIS-RC and WMS scores of the observation group were higher than those of the control group (all P<0.05). After treatment, the serum levels of IL-1β, TNF-α, NSE and Aβ in two groups were decreased (all P<0.05), and the levels of IL-1β, TNF-α, NSE and Aβ in the observation group were lower than those in the control group (all P<0.05). NSE and Aβ levels were negatively correlated with WAIS-RC and WMS scores (all P<0.05). Conclusions:Magnesium valproate sustained-release tablets combined with Qingxin Wendan decoction in the treatment of patients with BD manic episode were superior to magnesium valproate sustained-release tablets alone in reducing manic score, IL-1β, TNF-α, NSE and Aβ levels, and improving the cognitive function of patients. The use of QingxinWendan decoction on top of valproate extended-release tablet treatment for BD manic episode was superior to treatment with valproate extended-release tablets alone in reducing mania scores, IL-1β, TNF-α, NSE and Aβ levels, as well as improving patients' cognitive function.
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Objective:To investigate the efficacy of maintenance electroconvulsive therapy (MECT) combined with quetiapine treatment for manic episodes of bipolar disorder.Methods:A total of 103 patients with manic episodes of bipolar disorder received treatment in Kangci Hospital of Jiaxing from January 2019 to August 2020 and were included in this study. They were randomly divided into observation ( n = 46) and control groups ( n = 57). The observation group was given MECT combined with quetiapine treatment and the control group was treated with magnesium valproate sustained-release tablets combined with quetiapine. All patients received 4 weeks of treatment. Clinical efficacy, total hospital cost, drug cost during hospitalization, drug proportion, adverse reactions, and scores of the Bech-Rafaelsdn Mania Rating Scale and the Wisconsin Card Sorting Test pre- and post-treatment were compared between the two groups. Results:After 4 weeks of treatment, total response rate was significantly higher in the observation group than in the control group [76.09% (35/46) vs. 56.14% (32/57), χ2 = 4.45, P < 0.05]. In the observation group, total hospital cost, drug cost during hospitalization, and drug proportion were (16074.52 ± 1019.81) yuan, (1374.52 ± 619.81) yuan, and 8.70% respectively, which were not significantly different from those in the control group [(15618.14 ± 1550.34) yuan, (1261.14 ± 750.34) yuan, 10.53%, t = 1.71, 0.82, χ2 = 0.09, all P > 0.05]. After 4 weeks of treatment, Bech-Rafaelsdn Mania Rating score was significantly lower in the observation group than in the control group [(7.36 ± 3.04) points vs. (10.23 ± 2.37) points, t = 5.38, P < 0.001]. The number of wrong responses and the number of perseverative errors in the Wisconsin Card Sorting Test in the observation group were (40.45 ± 3.61) counts and (9.56 ± 1.39) counts, respectively, which were significantly lower than those in the control group [(48.59 ± 4.51) counts, (12.08 ± 1.25) counts, t = 10.17, 9.56, both P < 0.001]. The number of perseverative errors in the Wisconsin Card Sorting Test was significantly higher in the observation group than in the control group [(33.85 ± 2.50) counts vs. (29.71 ± 2.14) counts, t = 8.90, P < 0.001]. There was no significant difference in total incidence of adverse reactions between observation and control groups (21.74% vs. 22.81%, χ2 = 0.01, P > 0.05). Conclusion:MECT combined with quetiapine treatment is highly effective on the manic episodes of bipolar disorder. The combined therapy is worthy of clinical application.
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Objective:To investigate the efficacy of magnesium valproate versus lithium carbonate in the treatment of bipolar disorder and their effects on serum indexes and quality of life. Methods:80 patients with bipolar disorder treated in the Fifth People's Hospital of Zhuji City from March 2017 to May 2020 were included in this study. They were randomly assigned to receive either lithium carbonate (control group, n = 40) or magnesium valproate (treatment group, n = 40) for 3 months. Efficacy,serum indexes, and quality of life were compared between the two groups. Results:Total effective rate was significantly higher in the observation group than in the control group [95.0% (38/40) vs. 75.0% (30/40), χ2 = 6.28, P = 0.012]. There were no significant differences in tumor necrosis factor-α, uric acid, total bilirubin, and albumin levels between the two groups (all P > 0.05). Tumor necrosis factor-α and uric acid levels in each group were decreased after treatment compared with before treatment (both P < 0.001). Total bilirubin and albumin levels in each group were increased after treatment compared with before treatment (both P < 0.001). Tumor necrosis factor-2 and uric acid levels measured after treatment were (136.5 ± 6.2) ng/L and (307.9 ± 15.2) μmol/L, respectively in the observation group, which were significantly lower than those in the control group [(148.9 ± 7.5) ng/L, (335.6 ± 18.9) μmol/L in the control group, t = 12.20, 7.22, both P < 0.001]. Total bilirubin and albumin levels measured after treatment were (11.0 ± 2.3) μmol/L and (45.5 ± 3.6) g/L, respectively in the observation group, which were significantly higher than those in the control group [(8.4 ± 2.1) μmol/L, (42.8 ± 3.0) g/L, t = 5.28, 3.64, both P < 0.001). There were no significant differences in scores of all dimensions of quality of life between the two groups before treatment (all P > 0.05). Scores of all dimensions of quality of life in each group increased after treatment compared with befor treatment (all P < 0.001). Scores of physical functioning, physical role functioning, bodily pain, vitality, social role functioning, emotional role functioning, and mental health measured after treatment were (75.2 ± 4.4) points, (71.9 ± 4.6) points, (76.2 ± 4.7) points, (71.8 ± 3.9) points, (66.8 ± 4.0) points, (75.9 ± 4.4) points, (70.5 ± 3.9) points, and (69.9 ± 4.0) points respectively in the observation group, which were significantly higher than those in the control group [(68.0 ± 4.0) points, (65.5 ± 4.3) points, (69.8 ± 4.0) points, (66.5 ± 3.5) points, (61.8 ± 3.5) points, (68.1 ± 4.0) points, (64.1 ± 3.6) points, (63.3 ± 3.9) points, t = 7.66, 6.43, 6.56, 6.40, 5.95, 8.30, 7.63, 7.47, all P < 0.001]. Conclusion:Magnesium valproate for the treatment of bipolar disorder can improve the antioxidant capacity, inhibit immune-inflammatory injury, improve abnormal metabolism, effectively control the symptoms of depression and mania,and improve the quality of life. Magnesium valproate is more effective than lithium carbonate in the treatment of bipolar disease.
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Objective: To establish a GC determination method for the content and dissolution of magnesium valproate tablets. Methods:Magnesium valproate tablets were detected by a GC internal standard method. The samples were dissolved in 0. 1 mol·L-1 hydrochloric acid solution, and then extracted by dichloromethane. Eicosane was used as the internal standard. The dissolution was de-termined by the first method described in ChP 2015 edition. The dissolution medium was 0. 1 mol·L-1 hydrochloric acid solution and the rotation speed was 100 r·min-1 with the sampling time at 45 min. The samples were extracted by dichiormethane, and eicosane was used as the internal standard as well. Results: The dissolution of magnesium valproate tablets showed good linearity within the range of 0. 005-1. 000 mg·ml-1(r=0. 9999). The recovery was 99. 2% (RSD=0. 5%, n=9). The dissolution curve showed that magnesium valproate released above 80% in 45 minutes. Conclusion:The method has good specificity and high accuracy, and can be used for the content determination and dissolution detection of magnesium valproate tablets.
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Objective To investigate the influence of magnesium valproate and quetiapine separately combined with lithium carbonate on BRMS scores,PANSS scores and adverse effects of patients with manic episode of bipolar disorder in puberty. Methods 100 patients with manic episode of bipolar disorder in puberty were chosen and randomly divided into two groups according to the digital table. Group A ( 50 children ) was given magnesium valproate,and group B (50 children) was given quetiapine on the basis of lithium carbonate. The clinical efficacy,the BRMS score,PANSS score and WCST score before and after treatment and the incidence of adverse effects of the two groups were compared. Results There was no significant difference in clinical efficacy between the two groups (94. 00% vs. 90. 00%),(χ2 =1. 31,P>0. 05). After treatment for 2 weeks,the BRMS score,PANSS score and WCST score of group B were significantly better than those of group A and before treatment(t=2. 45,3. 16;2. 71,3. 26,2. 79, 3. 36,all P<0. 05). 6 weeksafter treatment,there were no significant differences in the BRMS score,PANSS score and WCST score between the two groups(t=1. 20,1. 08,1. 19,all P<0. 05). There was no significant difference in the incidence rate of adverse effects between the two groups(χ2 =1. 49,P>0. 05). Conclusion Two kinds of bigeminy drug therapy in the treatment of patients with manic episode of bipolar disorder in puberty possess the clinical effects and safety,and quetiapine combined with lithium can help to shorten the onset time and higher the compliance degree.
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Objective To investigate the influence of magnesium valproate and quetiapine separately combined with lithium carbonate on BRMS scores,PANSS scores and adverse effects of patients with manic episode of bipolar disorder in puberty. Methods 100 patients with manic episode of bipolar disorder in puberty were chosen and randomly divided into two groups according to the digital table. Group A ( 50 children ) was given magnesium valproate,and group B (50 children) was given quetiapine on the basis of lithium carbonate. The clinical efficacy,the BRMS score,PANSS score and WCST score before and after treatment and the incidence of adverse effects of the two groups were compared. Results There was no significant difference in clinical efficacy between the two groups (94. 00% vs. 90. 00%),(χ2 =1. 31,P>0. 05). After treatment for 2 weeks,the BRMS score,PANSS score and WCST score of group B were significantly better than those of group A and before treatment(t=2. 45,3. 16;2. 71,3. 26,2. 79, 3. 36,all P<0. 05). 6 weeksafter treatment,there were no significant differences in the BRMS score,PANSS score and WCST score between the two groups(t=1. 20,1. 08,1. 19,all P<0. 05). There was no significant difference in the incidence rate of adverse effects between the two groups(χ2 =1. 49,P>0. 05). Conclusion Two kinds of bigeminy drug therapy in the treatment of patients with manic episode of bipolar disorder in puberty possess the clinical effects and safety,and quetiapine combined with lithium can help to shorten the onset time and higher the compliance degree.
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Objective:To discuss the mechanism of the high risk factors for hemorrhage by the study on the combination of warfa-rin and magnesium valproate to provide reference for the rational drug selection. Methods:Clinical pharmacists analyzed and adjusted the antiepileptic drug treatment scheme for one patient with cerebral hemorrhage induced by the combination of warfarin and magnesium valproate after mitral valve replacement complicated with epilepsy.The adjusted scheme was as follows:magnesium valproate was sus-pended,0.25 g levetiracetam was used,po,bid,and then the dose was raised to 0.5 g after 14 days for the anti-epileptic treatment. Pharmaceutical care was performed during the whole process of the treatment. Results: After 20-day hospital stay, the international normalized ratio (INR) was controlled within the range of 2.5-3.0,and the patient was discharged in stable conditions with no occur-rence of epilepsy. Conclusion:Levetiracetam has few interactions with warfarin,suggusting the combination is reasonable.
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ObjectiveTo investigate the mechanisms and the effects of magnesium Valproate on the expressions of the kinin B1 and B2 receptors in the hippocampus of the juvenile rats submitted to pilocarpine model of epilepsy.Methods 35 healthy Wistar juvenile rats were randomly divided into six groups,that is the model groups:Ⅰ group,Ⅱ group,Ⅲ group,and intraperitoneal injection of saline water control groups:Ⅰ a group,Ⅱ a group,Ⅲ a group,after succession of 15 rats to kindle to establish the model of epilepsy by pilocarpine.To collect hippocampus tissue after the rats were to put to death,and to compared the expression levels of kinin B1 and B2 receptor mRNA by RT-PCR and western blot in the hippocampus of rats.ResultsBy treated with magnesium valproate,kinin B1 receptor mRNA (0.38 ± 0.051 ) and protein expressions(0.58 ± 0.057 ) decreased and kinin B2 receptor mRNA (0.48 ±0.056 ) and protein expressions(0.48 ± 0.044 ) increased in Ⅰ group,compared with that (0.76 ±0.068,0.89 ± 0.034;0.28 ± 0.034,0.32 ± 0.039 ) of Ⅰ a group(P ＜ 0.05 ).Compared with control group,there were more significant upregulation of kinin B1 receptor mRNA and protein expressions (P＜0.05) in the Ⅰ and the Ⅱ groups and there were no alteration in Ⅲ group.The expressional levels of B2 receptor mRNA and protein were upregulated in the Ⅰ,Ⅱ and Ⅲ groups.ConclusionThe kinin B1 and B2 receptor may play a role in the onset and maintenance of epilepsy.The magnesium valproate increased the expressional levels of kinin B2 receptor,and decreased the expressional levels of kinin B1 receptor.
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Objective To observe the effect of magnesium valproate sustained release tablets on children with epilepsy and its effects on cognitive function.Methods Magnesium valproate sustained release tablets were conducted on 38 cases.Close attention was paid to both the degree of paroxysm control and side effects during treatment while periodic examinations on liver function and blood routine were also conducted.The intelligence and P300 of children with epileptics were respectively measured before and after 6-month treatment.Forty children of control group was set up.Results Eighteen cases were totally under controlled(47.4%),11 obviously effect(28.9%),6 effect(15.8%).The total effective rate in total was 92.1%.Obvious differencees in intelligence between children with epileptics and control group before and after 6-month treatment were observed(all P0.05).Conclusions Magnesium valproate sustained release tablets is a new type of broad-spectrum anti-epileptic drug,which has an obvious effect on treatment of children with epileptic without any obvious adverse reaction.It imposes little influence on children′s cognitive function.