加味癫狂梦醒汤联合西药治疗难治性精神分裂症临床研究  

Clinical Study on Modified Diankuang Mengxing Decoction Combined with Western Medicine for Treatment-Resistant Schizophrenia

作　　者：贾文馨 曾欣 袁红卫 JIA Wenxin;ZENG Xin;YUAN Hongwei(Department of Psychiatry,The Second People's Hospital of Lishui,Lishui Zhejiang 323000,China;Department of Chinese Medicine Psychiatry,The Second People's Hospital of Lishui,Lishui Zhejiang 323000,China)

机构地区：[1]丽水市第二人民医院精神科,浙江丽水323000 [2]丽水市第二人民医院中医精神科,浙江丽水323000

出　　处：《新中医》2024年第12期21-25,共5页New Chinese Medicine

摘　　要：目的:观察加味癫狂梦醒汤联合西药治疗难治性精神分裂症(TRS)的临床疗效。方法:将108例TRS患者按随机数字表法分为治疗组和对照组各54例。对照组给予阿立哌唑加利培酮治疗,治疗组在对照组基础上给予加味癫狂梦醒汤治疗。治疗2个月后,比较2组临床疗效及药物不良反应发生率,治疗前后阳性和阴性症状量表(PANSS)评分、脑损伤标志物[血清脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、钙结合蛋白(S100β)]水平。结果:治疗组总有效率为94.44%,高于对照组81.48%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组阴性症状、阳性症状、一般精神病理评分及总分比较,差异均无统计学意义(P>0.05);治疗后,2组上述PANSS量表各维度评分及总分均较治疗前降低(P<0.05),且治疗组PANSS量表各维度评分及总分均低于对照组(P<0.05)。治疗前,2组血清BDNF、NSE、S100β水平比较,差异均无统计学意义(P>0.05)。治疗后,2组BDNF水平均较治疗前升高(P<0.05),NSE、S100β水平均较治疗前降低(P<0.05);且治疗组BDNF水平高于对照组(P<0.05),NSE、S100β水平低于对照组(P<0.05)。治疗组不良反应发生率为7.40%,低于对照组22.22%,2组比较,差异有统计学意义(P<0.05)。结论:针对TRS患者给予加味癫狂梦醒汤联合西药治疗可提高临床疗效,减轻患者临床症状,调节脑损伤标志物表达水平,减少药物不良反应。Objective:To observe the clinical effect of Modified Diankuang Mengxing Decoction combined with western medicine on patients with treatment-resistant schizophrenia(TRS).Methods:A total of 108 cases of patients with TRS were divided into the treatment group and the control group according to the random number table method,with 54 cases in each group.The control group was treated with Aripiprazole and Risperidone,and the treatment group was additionally treated with Modified Diankuang Mengxing Decoction based on the treatment of the control group.After two months of treatment,Positive and Negative Symptom Scale(PANSS)scores,brain injury markers[serum brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),calcium-binding protein(S100β)]levels before and after treatment as well as clinical effects and incidence of adverse drug reactions were compared between the two groups.Results:The total effective rate was 94.44%in the treatment group higher than that of 81.48%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of negative symptoms,positive symptoms,general psychopathological scores and total scores between the two groups(P>0.05).After treatment,the scores of all dimensions of PANSS scale and the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores in the treatment group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the comparison of the levels of BDNF,NSE and S100βin serum between the two groups(P>0.05).After treatment,the levels of BDNF in the two groups were increased when compared with those before treatment(P<0.05),and the levels of NSE and S100βwere decreased when compared with those before treatment(P<0.05);BDNF level in the treatment group was higher than that in the control group(P<0.05),and the levels of NSE and S100βin the treatment group were lower than those in the control gr

关 键 词：难治性精神分裂症 癫狂梦醒汤 阿立哌唑 利培酮 脑损伤标志物 

分 类 号：R749.3[医药卫生—神经病学与精神病学]