改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者的影响  

Effect of Improved Tongqiao Huoxuetang Combined with Valproate on Manic Episodes of Bipolar Disorder Patients

作　　者：王昉[1] 梅蕊[1] 彭樊[2] 吕路[1] 荣晗[3] 

机构地区：[1]武汉市精神卫生中心,武汉430022 [2]武汉市中医医院,武汉430010 [3]深圳市康宁医院,广东深圳518003

出　　处：《中国实验方剂学杂志》2017年第11期184-189,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：深圳市卫生和人口计划生育委员会立项(B2010286)

摘　　要：目的:探讨改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者疗效及对血液生化指标的影响。方法:选自2014年2月—2015年8月武汉市精神卫生中心收治的双相情感障碍躁狂发作患者104例,依据随机数字表法随机分为观察组与对照组,各52例。对照组采用丙戊酸钠缓释片治疗,观察组在对照组基础上结合改良通窍活血汤治疗。两组患者疗程均为8周。结果:观察组总有效率(94.23%)及不同证候有效率(96.00%,93.33%,91.67%)均高于对照组(73.08%,73.91%,77.78%,72.73%)(P<0.05);两组患者汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)总分及各因子评分治疗后明显下降(P<0.05);观察组HAMD总分及各因子评分治疗后明显低于对照组(P<0.05);与治疗前比较,两组患者狂躁量表(Bech-Rafaelsen Mania Rating Scale,BRMS)评分和生活质量综合评定问卷(Generic Quality of Life Inventory,GQL-LI)评分治疗后均明显下降(P<0.05);观察组BRMS评分和GQL-LI评分治疗后明显低于对照组(P<0.05);两组患者血清白细胞介素-1β(interleukin^(-1)β,IL^(-1)β),白细胞介素-4(interleukin-4,IL-4),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平治疗后明显下降(P<0.05);观察组IL^(-1)β,IL-4,TNF-α水平治疗后低于对照组(P<0.05);两组患者血浆白蛋白和总胆红素水平治疗后明显增加(P<0.05);观察组血浆白蛋白和总胆红素水平治疗后高于对照组(P<0.05);观察组不良反应发生率(7.69%)低于对照组(26.92%)(P<0.05)。结论:改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者疗效明显,可明显降低患者血清IL^(-1)β,IL-4,TNF-α水平,提高血浆白蛋白、总胆红素水平水平,且安全可靠。Objective： To explore the clinical efficacy of improved Tongqiao Huoxuetang combined with valproate for manic episodes in bipolar disorder patients and investigate its effect on biochemical indicators. Method： The 104 patients with manic episodes of bipolar disorder admitted to our hospital from February 2014- August 2015 were randomly divided into observation group （52 cases） and control group （52 cases）. Patients in control group received sodium valproate treatment, and patients in observation group received improved Tongqiao Huoxuetang treatment on the basis of treatment in control group. The course of treatment was 8 weeks in both groups. Result： The total effective rate （94.23%） and effective rates of different syndromes （96.00%, 93.33%, 91.67%） in observation group were higher than those in control group （73.08%, 73.91%, 77.78%, and 72.73% ） （P 〈 0.05）. Hamilton Depression Scale （HAMD） total scores and each factor scores were decreased significantly in both groups after treatment （P 〈 0. 05） ; the above scores in observation group were significantly lower than those in control group after treatment （P 〈 0.05）. After treatment, Bech-Rafaelsen Mania Rating Scale （BRMS） scores and Generic Quality of Life Inventory （GQL-LI） scores were decreased significantly in both groups （P 〈 0.05） ; and the above scores in observation group were significantly lower than those in control group after treatment （P 〈 0.05）. The serum levels of interleukin-1β （IL-1β） , interleukin4 （IL-4） and tumor necrosis factor-α（TNF-α） were significantly decreased after treatment in both groups （P 〈 0. 05） ; and the above levels in observation group were lower than those in control group after treatment （P 〈 0.05）. Plasma albumin and total bilirub in levels were increased in both groups after treatment （P 〈 0.05 ） ; and the above levels in observation group were higher than those in control group after treatment （P 〈 0.05）. The adverse

关 键 词：改良通窍活血汤 丙戊酸盐 双相情感障碍躁狂发作 疗效 白细胞介素-1Β 白细胞介素-4 肿瘤坏死因子-α 

分 类 号：R287[医药卫生—中药学]