芍药甘草汤联合阿立哌唑治疗利培酮所致精神分裂症患者高催乳素血症的临床疗效观察  

Observation of the clinical efficacy of Peony and Glycyrrhiza uralensis decoction combined with aripiprazole on hyperprolactinemia induced by risperidone in patients with schizophrenia

作　　者：徐雪燕[1] 赵静[1] 陆颖[1] 朱丽萍[1] XU Xue-yan;ZHAO Jing;LU Ying(Department of Clinical Psychiatry,Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai Institute of Traditional Chinese Medicine for Mental Disorders,Shanghai Mental Health Center,Shanghai 201108,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心、上海市中医神志病研究所、上海市精神卫生中心临床精神科,上海201108

出　　处：《临床和实验医学杂志》2025年第6期588-593,共6页Journal of Clinical and Experimental Medicine

基　　金：上海市科学技术委员会中医类引导项目(编号:19401932300)。

摘　　要：目的探究芍药甘草汤联合阿立哌唑治疗利培酮所致高催乳素血症(HPRL)的精神分裂症患者的临床疗效。方法前瞻性选择2022年1月至2023年6月在上海交通大学医学院附属精神卫生中心治疗的132例利培酮所致HPRL的精神分裂症患者作为研究对象,根据随机数字表法将其分为阿立哌唑组(n=66)、联合治疗组(n=66)。阿立哌唑组给予阿立哌唑治疗,联合治疗组在给予阿立哌唑治疗的基础上联用芍药甘草汤治疗。比较两组的临床疗效,治疗前(T_(0))、治疗8周后(T_(1))的性激素[泌乳素、雌二醇、孕酮、睾酮、卵泡生成素(FSH)]水平、内分泌功能指标[促肾上腺皮质激素(ACTH)、皮质醇]、免疫功能指标[自然杀伤(NK)细胞、CD3^(+)、CD4^(+)、CD8^(+)]、阳性与阴性症状量表(PANSS)评分及不良反应发生情况。结果联合治疗组患者临床总有效率为92.42%,显著高于阿立哌唑(80.30%),差异有统计学意义(P<0.05)。与T_(0)时相比,两组T_(1)时泌乳素水平显著降低,雌二醇、孕酮、FSH水平显著升高,且联合治疗组的泌乳素水平为(20.19±3.52)ng/mL,显著低于阿立哌唑组[(23.61±3.84)ng/mL],雌二醇、孕酮、FSH水平分别为(49.25±6.24)pg/mL、(8.25±1.96)ng/mL、(26.18±3.35)nmol/L,显著高于阿立哌唑组[(43.91±5.34)pg/mL、(6.84±1.68)ng/mL、(23.64±3.06)nmol/L],差异均有统计学意义(P<0.05)。与T_(0)时相比,两组T_(1)时ACTH、皮质醇均显著降低,且联合治疗组ACTH、皮质醇水平分别为(24.61±3.18)pg/mL、(218.34±48.53)nmol/L,均低于阿立哌唑组[(30.17±3.92)pg/mL、(359.64±84.31)nmol/L],差异均有统计学意义(P<0.05)。与T_(0)时相比,两组T_(1)时NK细胞、CD3^(+)、CD4^(+)水平显著升高,CD8^(+)水平显著降低,且联合治疗组NK细胞、CD3^(+)、CD4^(+)水平分别为(32.69±5.91)%、(66.81±6.95)%、(42.48±4.51)%,均高于阿立哌唑组[(25.64±5.16)%、(63.70±6.51)%、(36.35±4.08)%],CD8^(+)水平为(24.68±3.17)%,显著低于阿立哌�Objective To investigate the clinical efficacy of Peony and Glycyrrhiza uralensis decoction combined with aripiprazole on hyperprolactinemia(HPRL)induced by risperidone in patients with schizophrenia.Methods A total of 132 schizophrenic patients with risperidone-induced HPRL who were treated in the Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to June 2023 were prospectively selected as the study subjects.According to the random number table method,they were divided into the aripiprazole group(n=66)and the combined treatment group(n=66).The clinical efficacy,levels of sex hormones[prolactin,estradiol,progesterone,testosterone,follicle stimulating hormone(FSH)],endocrine function indexes[adrenocorticotropic hormone(ACTH),cortisol],immune function indexes[natural killer(NK)cell,CD3^(+),CD4^(+),CD8^(+)],positive and negative symptom scale(PANSS)before treatment(T_(0))and after 8 weeks of treatment(T_(1))and adverse reactions were compared between the two groups.Results The total effective rate of the combined treatment group was 92.42%,which was significantly higher than that of aripiprazole(80.30%),and the difference was statistically significant(P<0.05).Compared with T_(0),the prolactin levels at T_(1) in the two groups were significantly decreased,and the prolactin level in the combined treatment group was(20.19±3.52)ng/mL,which was significantly lower than that in the aripiprazole group[(23.61±3.84)ng/mL],the levels of estradiol,progesterone and FSH were(49.25±6.24)pg/mL,(8.25±1.96)ng/mL and(26.18±3.35)nmol/L,respectively,which were significantly higher than those in the aripiprazole group[(43.91±5.34)pg/mL,(6.84±1.68)ng/mL,(23.64±3.06)nmol/L],the differences were statistically significant.(P<0.05).Compared with T_(0),the levels of ACTH and cortisol in the two groups were significantly decreased at T_(1),andThe levels of ACTH and cortisol in the combined treatment group were(24.61±3.18)pg/mL and(218.34±48.53)nmol/L,respectively,which were lower th

关 键 词：精神分裂症 高催乳素血症 芍药甘草汤 阿立哌唑 临床疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]