涤痰汤加减联合电针治疗难治性精神分裂症疗效观察  

Clinical Observation on Modified Ditan Tang Combined with Electroacupuncture in the Treatment of Refractory Schizophrenia

作　　者：焦英霞 刘医农 谢春平 JIAO Yingxia;LIU Yinong;XIE Chunping(Psychiatry,Hengshui Seventh People's Hospital,Hengshui 053000,China)

机构地区：[1]衡水市第七人民医院精神科,河北衡水053000

出　　处：《西部中医药》2024年第9期115-119,共5页Western Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2023465)。

摘　　要：目的:观察涤痰汤加减联合电针治疗难治性精神分裂症的临床疗效、精神症状与安全性。方法:将难治性精神分裂症患者150例按随机数字表法分为对照组和试验组各75例。对照组予氯氮平治疗,试验组在对照组基础上予涤痰汤加减联合电针治疗,两组均治疗8周。比较两组患者临床疗效及治疗前后精神症状、社会功能、记忆、认知功能、事件相关电位P300、血清指标水平与不良反应发生情况。结果:治疗8周后试验组总有效率为93.33%(70/75),高于对照组的78.67%(59/75)(P<0.05);治疗8周后两组患者阳性和阴性症状量表评分、精神分裂症认知功能评定量表评分、事件相关电位P300潜伏期均降低(P<0.05),试验组降低更明显(P<0.05);治疗8周后两组患者社会功能量表评分、韦氏成人记忆量表评分、简易精神状态量表评分、事件相关电位P300波幅、血清褪黑素、5-羟色胺、脑源性神经营养因子均升高(P<0.05),试验组升高更明显(P<0.05)。试验组不良反应发生率为5.33%(4/75),低于对照组的16.00%(12/75)(P<0.034)。结论:涤痰汤加减联合电针可提高难治性精神分裂症患者临床疗效,改善患者精神症状、社会功能、记忆、认知功能,且具有较好的安全性。Objective:To observe clinical effects,mental symptoms and the safety of modified Ditan Tang(Phlegm-removing decoction)and electroacupuncture in treating refractory schizophrenia.Methods:All 150 patients were allocated to the control group and the experiment group using random number table method with 75 cases in each.The control group was treated with clozapine,and the experiment group was treated with modified Ditan Tang and electroacupuncture based on the control group,both groups were treated for eight weeks.To compare clinical effects of the two groups,psychiatric symptoms,social function,memory and cognitive function,event-related potential P300,the levels of serum indexes and the incidence of adverse reactions before and after the treatment.Results:After eight weeks of the treatment,total effective rate of the experiment group was 93.33%(70/75),higher than 78.67%(59/75)of the control group(P<0.05).After eight weeks of the treatment,the scores of the positive and negative syndrome scale(PANSS),schizophrenia cognition rating scale(SCoRS)and eventrelated potential P300 latency reduced in the two groups(P<0.05),the decrease of the experiment group was more evident(P<0.05).After eight weeks of the treatment,the scores of social functioning scale(SFS),Wechsler Memory Scale(WMS)and the Mini-Mental State Examination(MMSE),event-related potential P300 latency,the levels of serum melatonin,5-hydroxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)raised in the two groups(P<0.05),the increase of the experiment group was more obvious(P<0.05).The incidence of adverse reaction of the experiment group was 5.33%(4/75),lower than 16.00%(12/75)of the control group(P<0.034).Conclusion:Modified Ditan Tang and electroacupuncture in treating refractory schizophrenia could enhance clinical effects,improve the patients′psychiatric symptoms,social function,memory and cognitive function with better safety.

关 键 词：精神分裂症 难治性 精神症状 不良反应 涤痰汤 电针 

分 类 号：R749.3[医药卫生—神经病学与精神病学]