化痰开窍法联合氯氮平治疗精神分裂症的临床疗效及其对微小RNA、神经损伤因子的影响  

Clinical curative effect of treating schizophrenia by eliminating phlegm and opening orifice method with clozapine and its effects on miRNA and nerve injury factors

作　　者：袁鑫 赵永厚 徐闯 YUAN Xin;ZHAO Yong-hou;XU Chuang(Second Clinical School of Heilongjiang University of Traditional Chinese Medicine,Harbin Heilongjiang 150040,China;Department of Depression,Heilongjiang Mental Hospital,Harbin Heilongjiang 150036,China;Department of Cardiovascular medicine,First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040,China)

机构地区：[1]黑龙江中医药大学第二临床医学院,黑龙江哈尔滨150040 [2]黑龙江神志医院郁病科,黑龙江哈尔滨150036 [3]黑龙江中医药大学附属第一医院心血管内科,黑龙江哈尔滨150040

出　　处：《临床和实验医学杂志》2024年第5期477-481,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金委员会计划项目(编号:81973747);黑龙江省中医药科研项目(编号:ZHY2020-183);黑龙江省中医药管理局2022年度中医药科研课题(编号:ZHY2022-050)。

摘　　要：目的研究化痰开窍法联合氯氮平治疗精神分裂症(SZ)的临床疗效及其对微小RNA(miRNA)、神经损伤因子的影响。方法前瞻性选择2021年9月至2023年8月于黑龙江神志医院治疗的SZ患者80例,依据随机数字表法将其分为观察组(n=40)和对照组(n=40)。对照组行氯氮平治疗,观察组行化痰开窍法联合氯氮平治疗,两组均治疗4周。于治疗4周后,观察两组临床疗效。对比两组治疗前及治疗4周后激越行为、认知功能[简易视觉空间记忆测验修订版(BVMT-R)评分]、血清miR124、miR-132-3p miRNA水平、血清ɑ-突触核蛋白(ɑ-Syn)、硫酸脱氢表雄酮(DHEAS)水平及不良反应。结果观察组总有效率为95.00%,高于对照组(75.00%),差异有统计学意义(P<0.05)。治疗4周后,观察组紧张、兴奋、不合作、敌意、冲动控制障碍评分分别为(1.90±0.21)、(2.02±0.23)、(1.73±0.19)、(1.98±0.22)、(1.79±0.19)分,均低于对照组[(2.89±0.30)、(3.19±0.35)、(2.95±0.32)、(3.14±0.33)、(2.86±0.31)分],差异均有统计学意义(P<0.05)。治疗4周后,观察组3次BVMT-R评分分别为(6.63±0.69)、(9.56±0.98)、(10.64±0.33)分,均高于对照组[(5.78±0.60)、(8.45±0.87)、(9.15±0.93)分],差异均有统计学意义(P<0.05)。治疗4周后,观察组血清miR124、miR-132-3p水平分别为1.25±0.14、1.63±0.18,均低于对照组(1.60±0.18、2.05±0.23),差异均有统计学意义(P<0.05)。治疗4周后,观察组血清ɑ-Syn为(108.46±13.20)ng/L,高于对照组[(89.26±9.09)ng/L],DHEAS水平为(58.95±6.13)nmol/L,低于对照组[(70.82±7.40)nmol/L],差异均有统计学意义(P<0.05)。观察组不良反应为20.00%,与对照组(25.00%)比较,差异无统计学意义(P>0.05)。结论化痰开窍法联合氯氮平治疗SZ可抑制患者激越行为,改善其认知功能,降低血清miR124、miR-132-3p水平,避免患者神经功能损伤,疗效显著,安全性高。Objective To study the clinical effect of the treatment of schizophrenia(SZ)by eliminating phlegm and opening orifice method combined with clozapine and its effects on miRNA and nerve injury factors.Methods A total of 80 SZ patients treated in Heilongjiang Shenzhi Hospital from September 2021 to August 2023 were prospectatively selected,and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The control group was treated with clozapine,and the observation group was treated with eliminating phlegm and opening orifice method with clozapine,two groups were treated for 4 weeks.The clinical effect of the two groups were observed.The agitated behavior,Cognitive function[brief visuospatial memory test revised(BVMT-R)score,BVMT-R were performed three times];Serum miRNA levels such as miR124 and miR-132-3p;Serum alpha-Synuclein(ɑ-Syn),dehydroepiandrosterone sulfate(DHEAS)and other nerve damage factors of the two groups before and after 4 week of treatment and adverse reaction were observed.Results The total effective rate of observation group were 95.00%,which were higher than that of control group(75.00%),the difference was statistically significant(P<0.05).After 4 week of treatment,the scores of tension,excitement,uncooperation,hostility and impulse control disorder in the observation group were(1.90±0.21),(2.02±0.23),(1.73±0.19),(1.98±0.22),(1.79±0.19)scores,respectively,which were lower than those in the control group[(2.89±0.30),(3.19±0.35),(2.95±0.32),(3.14±0.33),(2.86±0.31)scores],and the differences were statistically significant(P<0.05).The three BVMT-R scores of the observation group were(6.63±0.69),(9.56±0.98)and(10.64±0.33)scores,respectively,which were higher than those of the control group[(5.78±0.60),(8.45±0.87)and(9.15±0.93)scores],and the differences were statistically significant(P<0.05).The levels serum of miR124 and miR-132-3p in the observation group were 1.25±0.14 and 1.63±0.18,respectively,which were lower than those in th

关 键 词：精神分裂症 化痰开窍法 氯氮平 认知功能 微小RNA 神经损伤因子 

分 类 号：R749.3[医药卫生—神经病学与精神病学]