天麻钩藤饮对服用阿立哌唑精神分裂症患者生活质量的影响  

Effect of TianmaGouteng decoction on quality of life in schizophrenic patients taking aripiprazole

作　　者：赵静[1] 陆颖[1] 陈剑华[1] 朱玉华[1] 琚明亮[1] 孙萍[1] 陈妍[1] 龙彬[1] 朱丽萍[1] Zhao Jing;Lu Ying;Chen Jianhua;Zhu Yuhua;Ju Mingliang;Sun Ping;Chen Yan;Long Bin;Zhu Liping(Psychiatry Department,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 201108,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心临床精神科,201108

出　　处：《神经疾病与精神卫生》2019年第12期1049-1055,共7页Journal of Neuroscience and Mental Health

基　　金：上海市科学技术委员会科研计划项目(16401934700,17401932600,19401932300);上海市精神卫生中心科研课题(2017-YJ-06,2018-YJ-09);上海市卫生健康委员会中医重点专科培育项目。

摘　　要：目的评价天麻钩藤饮对精神分裂症出现锥体外系不良反应患者的生活质量的影响.方法将90例患者随机分入天麻钩藤饮组(研究组)和盐酸苯海索组(对照组),随访8周.应用不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)、锥体外系反应量表(Rating scale for extrapyramdal side effects,RSESE)、健康状况调查问卷(MOS Item Short-Form Health Survey,SF-36)量表及不良反应量表(Treatment Emergent Symptom Scale,TESS)在治疗前后评估患者的锥体外系不良反应、生活质量、不良反应情况.结果(1)两组间AIMS量表、RSESE量表治疗前后变化差值差异无统计学意义(均P>0.05).(2)经重复测量方差分析,主效应分析:干预后情感职能、精神健康总评、健康变化自评的时间主效应有统计学意义(P<0.05),组间主效应两组间差异没有统计学意义(均P>0.05),生理功能、生理职能、总体健康感、躯体健康总评、总分存在交互作用(P<0.05).单独效应分析:研究组在生理功能、生理职能、总体健康感、躯体健康总评、总分方面治疗前后差异有统计学意义(均P<0.01);对照组在生理功能、躯体健康总评方面治疗前后差异有统计学意义(均P<0.05).(3)治疗后,研究组生理功能改善与AIMS、RSESE量表改善(r=0.385,P=0.012;r=0.381,P=0.012)以及生理职能改善与AIMS、RSESE量表改善(r=0.416,P=0.006;r=0.314,P=0.040)均呈低度正相关,总体健康感改善与RSESE量表改善呈低度正相关(r=0.342,P=0.025),SF-36总分改善与AIMS改善呈低度正相关(r=0.300,P=0.007),躯体健康总评的改善与AIMS、RSESE量表改善呈低度及微弱正相关(r=0.338,P=0.002;r=0.275,P=0.011).(4)两组间TESS症状严重度单项分治疗前后评分比较差异有统计学意义(Z=-3.506,P<0.001).结论天麻钩藤饮可以改善精神分裂症患者的生活质量,可能与其改善锥体外系不良反应的作用相关,且不良反应小于盐酸苯海索.Objectives To evaluate the effect of TianmaGouteng decoction on the quality of life of patients with extrapyramidal adverse reactions in schizophrenia.Methods A total of 90 patients were randomly divided into TianmaGouteng decoction group(study group)and Benzhexol group(control group).The patients were followed up for 8 weeks.The extrapyramidal adverse reactions,quality of life and adverse reactions were evaluated by Abnormal Involuntary Movement Scale(AIMS),Rating Scale for ExtrapyramdalSide Effects(RSESE),MOS Item Short-Form Health Survey(SF-36)and Treatment Emergent Symptom Scale(TESS)before and after treatment.Results(1)There was no difference in the changes in AIMS and RSESE between the two groups before and after treatment(P>0.05).(2)The main effects analysis of the repeated-measures analysis of variance shows that the time main effects of role limitations due to emotional problems(RE),mental component summary(MCS)and health transitions(HT)changes after intervention are statistically significant(P<0.05);There was no significant difference in the main effect between the two groups(all P>0.05);but interaction effects were statistically significant in physical functioning(PF),roe limitations due to physical health(RP),general health perceptions(GH),physical component summary(PCS)and total score of SF-36(P<0.05).Individual effect analysis shows there were significant differences in PF,RP,GH,PCS and total score of SF-36 in the study group before and after treatment,with statistical significance(all P<0.01).There were significant differences in PF,PCS in the control group before and after treatment,with statistical significance(all P<0.05).(3)After treatment,the improvement of AIMS scale and RSESE scale in the study group was positively correlated with the improvement of PF(r=0.385,P=0.012;r=0.381,P=0.012)and RP(r=0.416,P=0.006;r=0.314,P=0.040),the improvement of GH was positively correlated with the improvement of RSESE scale(r=0.342,P=0.025).The improvement of total score of SF-36 was positively correlated with

关 键 词：精神分裂症 天麻钩藤饮 锥体外系不良反应 生活质量 

分 类 号：R74[医药卫生—神经病学与精神病学]