调胃承气汤治疗精神分裂症伴代谢综合征应用价值  

Application Value of Tiaowei Chengqi Decoction(调胃承气汤)in Treating Schizophrenia with Metabolic Syndrome

作　　者：张荣荣 朱凤英 刘医农 ZHANG Rongrong;ZHU Fengying;LIU Yinong(Hengshui Seventh People′s Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市第七人民医院,河北衡水053000

出　　处：《辽宁中医杂志》2025年第2期48-52,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨精神分裂症(schizophrenia,SCZ)伴代谢综合征(metabolic syndrome,MS)患者采用调胃承气汤治疗的效果。方法采用随机数字表法将于2020年12月-2023年6月在衡水市第七人民医院接受治疗的110例SCZ伴MS患者分为A组和B组,各55例。A组给予盐酸二甲双胍片,B组在A组基础上给予调胃承气汤。两组治疗拍时间均为8周。比较两组治疗8周后的临床疗效,治疗前、治疗4、8周后的病情严重程度,治疗前、治疗8周后的糖脂代谢、5-羟色胺(5-hydroxytryptamine,5-HT)、褪黑素(melatonin,MT)、白细胞介素-17(interleukin-17,IL-17)、脑源性神经营养因子(brain derived neurotrophic factor,BDNF)、中髓鞘碱性蛋白(myelin basic protein,MBP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),治疗期间的不良反应。结果与A组比较,B组治疗8周后的总有效率更高[92.73%(51/55)vs 70.91%(39/55),P<0.05]。治疗4、8周后,两组病情严重程度(scores of severity of illness,CGI-SI)评分呈降低趋势,与A组比较,B组更低(P<0.05)。B组治疗4周后的血清高密度脂蛋白(high-density lipoprotein,HDL)水平比治疗前高,且与A组比较,B组更高;两组血清糖化血红蛋白(glycated hemoglobin,HbAlc)、空腹血糖(fasting blood glucose,FBS)及B组血清低密度脂蛋白(low-density lipoprotein,LDL)水平均比治疗前低,且与A组比较,B组更低(P<0.05)。两组治疗4周后的血清5-HT、MT、BDNF水平均比治疗前高,且与A组比较,B组更高;两组治疗4周后的血清IL-17、MBP、TNF-α水平均比治疗前低,且与A组比较,B组更低(P<0.05)。B组治疗期间的口干、恶心呕吐腹泻发生率均低于A组[5.45%(3/55)vs 23.64%(13/55),0.00%(0/55)vs 14.55%(8/55),P<0.05]。结论调胃承气汤可有效促进SCZ伴MS患者病情严重程度的缓解,减轻患者炎症损伤,并调节患者糖脂代谢指标及血清5-HT、MT水平,进而获得更高的临床疗效,且安全性较高。Objective To explore the therapeutic effect of Tiaowei Chengqi Decoction(调胃承气汤)on patients with schizophrenia(SCZ)and metabolic syndrome(MS).Methods A hundred and ten patients with SCZ and MS admitted to the Seventh People′s Hospital of Hengshui from December 2020 to June 2023 were divided into the group A and the group B by random number table method,55 cases in each group.The group A was given Metformin Hydrochloride Tablets,while the group B was given Tiaowei Chengqi Decoction on the basis of the group A.The treatment time for both groups was 8 weeks.The clinical efficacy after 8 weeks of treatment,including the severity of the condition before treatment,after 4 and 8 weeks of treatment,glucose and lipid metabolism,the levels of 5-hydroxytryptamine(5-HT),melatonin(MT),interleukin-17(IL-17),brain derived neurotrophic factor(BDNF),myelin basic protein(MBP)and tumor necrosis factor-α(TNF-α),and adverse reactions during treatment before and after 8 weeks of treatment of two groups were compared.Results Compared with that of the group A,the rate of total effective in the group B after 8 weeks of treatment was higher(92.73%(51/55)vs 70.91%(39/55),P<0.05).After 4 and 8 weeks of treatment,the scores of severity of illness(CGI-SI)showed a decreasing trend in both groups,and compared with the group A,the group B had a lower score(P<0.05).The level of serum high-density lipoprotein(HDL)in the group B after 4 weeks of treatment was higher than that before treatment,and compared with that of the group A,the level of the group B was higher.The levels of serum fasting blood glucose(FBS)and glycated hemoglobin(HbAlc)in both groups and low-density lipoprotein(LDL)in the group B were lower than those before treatment,and compared with those of the group A,the levels of the group B were lower(P<0.05).The levels of serum 5-HT,MT and BDNF in both groups after 4 weeks of treatment were higher than those before treatment,and compared with those of the group A,the levels of the group B were higher.The levels of serum IL

关 键 词：精神分裂症 代谢综合征 调胃承气汤 糖脂代谢 

分 类 号：R277.7[医药卫生—中医学]