加味温胆汤联合利培酮对痰湿内阻型精神分裂症阴性症状及对执行功能的影响  

Efficacy of the Wendan decoction plus risperidone on negative symptoms and executive function of patients with phlegm-dampness internal obstruction type of schizophrenia

作　　者：李一兰 李淑云 朱志敏 卢林生 刘赟[1] 王西林 LI Yilan

机构地区：[1]广州医科大学附属脑科医院,广东广州510370

出　　处：《中医临床研究》2023年第35期55-59,共5页Clinical Journal Of Chinese Medicine

基　　金：广东省中医药局科研项目(20222178):加味温胆汤联合抗精神病药物治疗痰湿内阻型精神分裂症阴性症状及神经认知功能的疗效研究;广东省中医药局科研项目(20211305):补气温阳定狂汤治疗虚阳上浮型躁狂症的疗效观察;广东省医学科学技术研究基金项目(B2022290):精神科急诊患者自伤自杀行为快速识别及应急处置的相关研究。

摘　　要：目的:探讨加味温胆汤联合利培酮对痰湿内阻型精神分裂症阴性症状及执行功能的影响。方法:选择广州医科大学附属脑科医院于2020年5月-2022年9月收治的精神分裂症患者80例,依据随机数字表法将其分为观察组与对照组,每组40例。对照组患者给予利培酮治疗,观察组在对照组基础上结合加味温胆汤治疗。两组均以4周为一个疗程,连续服用8周。比较两组治疗8周后的临床疗效,以及治疗前、治疗8周后阳性和阴性症状量表(Positive and Negative Symptom Scale, PANSS)评分、临床总体印象量表(Clinical Global Impression,CGI)评分、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评分、威斯康星卡片分类测试(Wisconsin Card Sorting Test,WCST)指标、汉诺塔(Tower of Hanoi,TOH)指标及不良反应情况。结果:观察组总有效率高于对照组(P <0.05)。两组治疗8周阴性症状和PANSS总分低于治疗前(P <0.05),且观察组治疗8周后阴性症状和PANSS总分低于对照组(P <0.05)。两组治疗8周后CGI评分低于治疗前(P <0.05),且观察组治疗8周后CGI评分低于对照组(P <0.05)。两组治疗8周后PSQI评分低于治疗前(P <0.05),且观察组治疗8周后PSQI评分低于对照组(P <0.05)。观察组治疗8周后WCST分类数、TOH总分高于治疗前(P <0.05),WCST错误总数、WCST持续错误数、TOH计划时间、TOH执行时间低于治疗前(P <0.05),且观察组治疗8周后WCST分类数、WCST错误总数、TOH计划时间、TOH总分优于对照组(P <0.05)。观察组不良反应发生率低于对照组(P <0.05)。结论:加味温胆汤联合利培酮治疗痰湿内阻型精神分裂症患者疗效显著,可改善患者阴性症状,减轻患者病情,改善患者睡眠质量和执行功能,且可减少不良反应。Objective:To investigate the effect of the Wendan decoction(温胆汤)plus risperidone on negative symptoms and executive function of patients with phlegm-dampness internal obstruction type of schizophrenia.Methods:A total of 80 patients with schizophrenia from May 2020 to September 2022 were selected and divided into the observation group of 40 cases and theO control group of 40 cases according to the random number table method.The patients in the control group were treated with risperidone,and the patients in the observation group were treated with the Wendan decoction on the basis of the treatment in the control group.Both groups took 4 weeks as a course of treatment,for 8 consecutive weeks.The clinical efficacy in the two groups after 8 weeks of treatment was compared before treatment and after 8 weeks of treatment.The PANSS score,CGI score,PSQI score,WCST indicators,TOH indicator and adverse reactions in both group were compared before and after treatment.Results:The total efficiency in the observation group was higher than that in the control group(P<0.05).After 8 weeks of treatment,the negative symptoms and PANSS total scores in the two groups were lower than before treatment(P<0.05),and those in the observation group were lower than the control group(P<0.05).After 8 weeks of treatment,CGI score in both groups were lower than before treatment(P<0.05),and in the observation group was lower than the control group(P<0.05).After 8 weeks of treatment,PSQI score in the two group were lower than before treatment(P<0.05),and in the observation group was lower than the control group.After 8 weeks of treatment,WCST classification number and TOH total score in the observation group were higher than before treatment(P<0.05),and WCST errors,WCST persistent errors,TOH planning time and TOH executive time were lower than before treatment(P<0.05).After 8 weeks of treatment,the WCST classification number,WCST total errors,TOH planning time and TOH total scores in observation group were better than the control group(P<0.05)

关 键 词：加味温胆汤 痰湿内阻型 精神分裂症 阴性症状 执行功能 

分 类 号：R277.7[医药卫生—中医学]