当归承气合剂对奥氮平治疗精神分裂症增效作用的临床研究  

Clinical study on the synergistic effect of Danggui Chengqi mixture on olanzapine in the treatment of schizophrenia

作　　者：琚明亮 赵静 张蔚蔚 罗梦依 施富丽 朱丽萍[1] 龙彬 JU Mingliang;ZHAO Jing;ZHANG Weiwei(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,上海市201108

出　　处：《精神医学杂志》2021年第4期295-299,共5页Journal of Psychiatry

基　　金：上海市科学技术委员会科研计划项目(编号:16401934700,17401932600,19401932300);上海市卫生健康委员会中医重点专科培育项目(编号:AB83180002019021);上海市综合医院中西医结合专项(编号:ZHYY-ZXYJHZX-202004)。

摘　　要：目的探讨当归承气合剂对奥氮平治疗精神分裂症的增效作用。方法选取接受奥氮平治疗的精神分裂症患者91例,分为研究组47例和对照组44例,分别给予当归承气合剂和当归承气合剂安慰剂口服,持续干预8周,分别于治疗前及治疗后第2、4、8周末采用阳性与阴性症状量表(PANSS)评定患者精神症状,于治疗前及治疗后第8周末采用重复性成套神经心理状态测验(RBANS)和治疗不良反应量表(TESS)评定认知功能和药物不良反应。结果两组治疗后第2、4、8周末PANSS总分及阳性症状、一般精神病理评分均较治疗前降低(P<0.05),研究组治疗后第2、4、8周末PANSS阴性症状评分较治疗前降低(P<0.05);治疗后第8周末研究组PANSS总分及阳性症状、阴性症状评分均低于对照组(P<0.05)。研究组治疗后第8周末RBANS总分及即刻记忆、视觉广度、注意评分均较治疗前升高(P<0.05),对照组治疗后第8周末RBANS注意评分较治疗前升高(P<0.05);治疗后第8周末研究组RBANS总分及即刻记忆、注意评分均高于对照组(P<0.05)。研究组患者便秘、体重增加两项不良反应的发生率均低于对照组(P<0.05)。结论当归承气合剂联合奥氮平治疗精神分裂症不仅会提高奥氮平的疗效,还可以改善患者的认知症状,并且减轻奥氮平的不良反应,值得临床推广。Objective To explore the synergistic effect of Danggui Chengqi mixture on olanzapine in the treatment of schizophrenia.Methods A total of 91 schizophrenic patients treated with olanzapine were selected and divided into study group(47 cases)treated with Danggui Chengqi mixture and control group(44 cases)treated with Danggui Chengqi mixture placebo for 8 weeks.They were assessed with Positive and Negative Syndrome Scale(PANSS)before treatment and at the 2nd,4th and 8th weekends after treatment,and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),Treatment Emergent Symptom Scale(TESS)before treatment and at the 8th weekend after treatment.Results At the 2nd,4th and 8th weekends after treatment,the total score and factor scores of positive symptoms,general psychopathology of PANSS in both groups decreased significantly compared with those before treatment(P<0.05).At the 2nd,4th and 8th weekends after treatment,the factor scores of negative symptoms of PANSS in study group decreased significantly compared with that before treatment(P<0.05).At the 8th weekend after treatment,the total score and factor scores of positive symptoms,negative symptoms of PANSS in study group were all significantly lower than those in control group(P<0.05).At the 8th weekend after treatment,the total score and factor scores of immediate memory,vision span,attention of RBANS in study group increased significantly compared with those before treatment(P<0.05);the factor score of attention of RBANS in control group increased significantly compared with that before treatment(P<0.05);and the total score and factor scores of immediate memory,attention of RBANS in study group were all significantly higher than those in control group(P<0.05).The incidence rates of constipation and weight gain in study group were lower than those in control group(P<0.05).Conclusion Danggui Chengqi mixture combined with olanzapine in the treatment of schizophrenia can not only improve the efficacy of olanzapine,but also improve the cognitive sy

关 键 词：当归承气合剂 奥氮平 精神分裂症 增效治疗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]