癫狂梦醒汤联合利培酮对癫狂病患者认知功能及个人和社会功能的影响  

Impacts of the Diankuang Mengxing Decoction combined with risperidone on cognitive function,personal and social function in patients with epilepsy

作　　者：张弘国 杨兆南 刘文佳 安春平[1] ZHANG Hong-guo;YANG Zhao-nan;LIU Wen-jia(Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040,China;Center of Mental Psychology,The First Specialized Hospital of Harbin,Harbin Heilongjiang 150000,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]哈尔滨市第一专科医院精神心理中心,黑龙江哈尔滨150000

出　　处：《临床和实验医学杂志》2025年第3期319-323,共5页Journal of Clinical and Experimental Medicine

基　　金：黑龙江省科技计划项目(编号:2022HJ302)。

摘　　要：目的探讨癫狂梦醒汤联合利培酮对癫狂病患者认知功能、个人和社会功能的影响。方法前瞻性选取2022年10月至2024年3月哈尔滨市第一专科医院收治的100例癫狂病患者,按照随机数字表法将其分为利培酮组和联合组,每组各50例。利培酮组给予利培酮治疗:利培酮1 mg/次,2次/d,治疗1周后将剂量增加至4~6 mg/d,连续治疗12周。联合组给予癫狂梦醒汤联合利培酮治疗:利培酮治疗同利培酮组,癫狂梦醒汤1剂/d,连续治疗12周。记录两组患者的疗效,治疗前、治疗12周后的症状严重程度[阳性和阴性精神症状评定量表(PANSS)评分]、认知功能[精神分裂症认知功能成套测验(MCCB)评分]、个人与社会表现量表(PSP)评分、血清学指标[神经生长因子(NGF)、脑源性神经营养因子(BDNF)、胶质纤维酸性蛋白(GFAP)]水平变化情况,并观察两组不良反应发生情况。结果联合组总有效率为92.00%,显著高于利培酮组(76.00%),差异有统计学意义(P<0.05)。治疗12周后,两组患者的PANSS评分均较治疗前降低,联合组PANSS评分为(36.14±4.11)分,低于利培酮组[(48.35±4.96)分],差异均有统计学意义(P<0.05)。治疗12周后,两组患者的MCCB评分、PSP评分均较治疗前升高,联合组MCCB评分、PSP评分分别为(52.24±5.36)、(77.22±8.06)分,均高于利培酮组[(49.13±5.11)、(64.29±7.22)分],差异均有统计学意义(P<0.05)。治疗12周后,两组患者的NGF、BDNF水平均较治疗前升高,GFAP水平均较治疗前降低,且联合组NGF、BDNF水平分别为(46.86±8.51)、(39.24±6.62)μg/L,均高于利培酮组[(40.37±8.09)、(33.72±5.87)μg/L],GFAP水平为(1.86±0.24)μg/L,低于利培酮组[(2.24±0.43)μg/L],差异均有统计学意义(P<0.05)。联合组总不良反应发生率为4.00%,与利培酮组(10.00%)比较,差异无统计学意义(P>0.05)。结论采用癫狂梦醒汤联合利培酮对癫狂病患者进行治疗可提升疗效,缓解阳性及阴性症状,改善患者认Objective To investigate the impacts of Diankuang Mengxing Decoction combined with risperidone on cognitive function,personal and social function in patients with epilepsy.Methods One hundred patients with madness admitted to The First Specialized Hospital of Harbin from October 2022 to March 2024 were prospectively selected and divided into the risperidone group and the combined group according to the random number table method,with 50 cases in each group.The risperidone group was given risperidone treatment:risperidone 1 mg/time,2 times/d,after 1 week of treatment,the dose was increased to 4-6 mg/d for 12 weeks.The combined group was treated with Diankuang Mengxing Decoction combined with risperidone:risperidone treatment was the same as risperidone group,Diankuang Mengxing Decoction 1 dose/d,continuous treatment for 12 weeks.The efficacy,the severity of symptoms[Positive and Negative Symptom Scale(PANSS)score],cognitive function[MATRICS Consensus Cognitive Battery(MCCB)score]and Personal and Social Performance Scale(PSP)score,serum indexes[nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),glial fibrillary acidic protein(GFAP)]changes before and after 12 weeks of treatment were recorded,and the incidence of adverse reactions in the two groups were observed.Results The total effective rate of the combined group was 92.00%,which was significantly higher than that of the risperidone group(76.00%),and the difference was statistically significant(P<0.05).After 12 weeks of treatment,the PANSS scores of the two groups were lower than those before treatment.The PANSS score of the combined group was(36.14±4.11)points,which was lower than that of the risperidone group[(48.35±4.96)points],and the difference was statistically significant(P<0.05).After 12 weeks of treatment,the MCCB score and PSP score of the two groups were higher than those before treatment,the MCCB score and PSP score of the combined group were(52.24±5.36)and(77.22±8.06)points,respectively,which were higher than those of the risperidon

关 键 词：精神分裂症 癫狂病 癫狂梦醒汤 利培酮 认知功能 个人与社会表现量表评分 

分 类 号：R742.1[医药卫生—神经病学与精神病学]