自拟中药化狂益智汤对阳性症状为主精神分裂症的治疗作用  

HuakuangYizhi Tang in the treatment of positive subtype schizophrenia:Comparative therapeutic effect study

作　　者：李晓琼[1] 甘景梨[2] 杨家明 段惠峰[2] 谭西英 杨代德[2] 张东卫[2] 蒋战魁 

机构地区：[1]91医院,河南焦作454003 [2]91医院全军精神疾病防治中心,河南焦作454003 [3]91医院影像中心,河南焦作454003

出　　处：《实用医药杂志》2012年第1期8-11,14,共5页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨化狂益智汤对阳性症状为主的精神分裂症患者前额叶和丘脑神经生化代谢物质的影响。方法阳性症状为主的精神分裂症患者64例纳入研究,治疗8周,33例给予利培酮联合化狂益智汤口服(试验组),31例给予利培酮口服(对照组)。分别于治疗前后采用多体素磁共振质子波谱(1H-MRS)检测前额叶和丘脑N-乙酰基天门冬氨酸(N-acetylaspartate,NAA)、胆碱复合物(choline-congtaining compounds,Cho)与肌酸复合物(creatine compounds,Cr),完成NAA/Cr值、Cho/Cr值的计算;采用阳性与阴性症状量表(positive and negativesyndrome scale,PANSS)评定临床症状和疗效,治疗中需处理的不良反应症状量表(treatment emergent symptomscale,TESS)评估治疗过程中的不良反应。结果试验组治疗后左侧前额叶、左侧丘脑NAA/Cr值为1.57±0.32,较治疗前的1.40±0.31高(P<0.05);对照组治疗后前额叶和丘脑NAA/Cr值、Cho/Cr值与治疗前均无显著性差异(P>0.05)。两组治疗后PANSS总分、阳性症状分、阴性症状分及一般病理分均显著低于治疗前(P<0.01);两组之间比较,治疗前、治疗后PANSS总分及各因子分均无显著性差异(P>0.05)。试验组利培酮平均治疗剂量(3.05±0.33)mg/d、最大剂量(3.42±0.41)mg/d,均小于对照组的(3.68±0.36)mg/d、(4.25±0.49)mg/d(P<0.01)。两组治疗效果、不良反应的发生率均无显著性差异(P>0.05)。结论化狂益智汤对阳性症状为主的精神分裂症患者某些脑区的神经元损害可能有一定的改善作用。Objective To study the potential effects of HuakuangYizhi Tang （Decoction of Chinese traditional drugs） on prefrontal lobe and thalamus of positive subtype schizophrenics by proton magnetic resonance spectroscopy（1H-MRS）. Methods Sixty-four positive subtype schizophrenics were randomly divided into two groups： 33 schizophrenics received the combined treatment of risperidone and HuakuangYizhi Tang （the trial group）, 31 schizophrenics treated with risperidone （the control group）. They were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS before and after 8 weeks＇ treatment. The N-aeetylaspartate （NAA）, choline-congtaining compounds （Cho）, and creatine compounds （Cr） were measured and the ratios of NAA/Cr, Cho/Cr were determined. The patients were also received positive and negative syndrome scale （PANSS） to evaluate the clinical symptoms at pre-treatment and post-treatment, and treatment emergent symptom scale （TESS） to assess the adverse reaction. Results On left prefrontal lobe and left thalamus, the NAA/Cr ratio in the trial group at post-treatment demonstrated higher than at pre-treatment[（1.57±0.33） vs （1.40±0.31）, P〈0.05;（1.57±0.32） vs （1.41±0.30）, P〈0.05]. Compared with pre-treatment, there were no significant differences in both the ratios of NAA/Cr and Cho/Cr at post-treatment in the control group （P〉0.05）. The PANSS total score, positive syndrome score, negative syndrome score and general psychopathology score in both groups decreased significantly after treatment （P〈0.01）. Compared with the control group, there were no significant differences in PANSS scores both at pre-treatment and posttreatment in the trial group （P〉0.05）. Both the mean dose and the maximum dose of risperidone in the trial group were lower than those in the control group [（3.05±0.33） mg/d vs （3.68±0.36） mg/d, P〈0.01; （3.42±0.41） mg/d vs （4.25±0.49） mg/d,P〈0.01]. There were no significant differences between the two g

关 键 词：化狂益智汤 精神分裂症 阳性症状为主 治疗 磁共振波谱 前额叶 丘脑 

分 类 号：R749.3[医药卫生—神经病学与精神病学]