摘要
目的 探讨加味涤痰汤联合注射用利培酮微球(Ⅱ)治疗痰气郁结证难治性精神分裂症的效果。方法 选择2021年9月至2023年6月收治的痰气郁结证难治性精神分裂症98例,按随机数字表法分为观察组和对照组各49例。观察组予以加味涤痰汤联合注射用利培酮微球(Ⅱ)治疗,对照组予以注射用利培酮微球(Ⅱ)治疗。比较2组临床疗效及治疗前后中医证候积分、记忆功能[韦氏记忆量表(WMS-RC)]、认知功能[精神分裂症认知功能成套测验共识版(MCCB)]、血清因子指标[神经细胞黏附分子(NCAM)、儿茶酚-O-甲基转移酶(COMT)、巨噬细胞迁移抑制因子(MIF)]。比较2组不良反应及锥体外系反应[辛普森-安格斯量表(SAS)、静坐不能量表(BARS)、不自主运动量表(AIMS)]发生情况。结果 观察组总有效率[97.96%(48/49)]高于对照组[83.67%(41/49)],差异有统计学意义(P<0.05)。观察组治疗8周后精神抑郁、神志呆钝、胸闷叹息、忧虑多疑、自语或不语评分均低于对照组,WMS-RC评分、MCCB评分高于对照组(P<0.05)。观察组治疗8周后血清NCAM水平高于对照组,COMT、MIF水平低于对照组(P<0.05)。2组不良反应发生率、不良反应程度及SAS、BARS、AIMS评分比较差异无统计学意义(P>0.05)。结论 加味涤痰汤联合注射用利培酮微球(Ⅱ)治疗痰气郁结证难治性精神分裂症疗效确切,可改善临床症状,提高记忆、认知功能,减轻病情程度,且具有一定安全性。
Objective To investigate the efficacy of Modified Ditan decoction combined with risperidone microspheres for injection(Ⅱ) in the treatment of refractory schizophrenia with phlegm-qi stagnation syndrome.Methods A total of 98 patients with intractable schizophrenia due to phlegm-qi stagnation syndrome admitted from September 2021 to June 2023 were selected.These patients were divided into an observation group and a control group,with 49 patients in each group,using a random number table method.The observation group was treated with Modified Ditan decoction combined with risperidone microspheres for injection(Ⅱ),while the control group was treated with risperidone microspheres for injection(Ⅱ).The clinical efficacy,as well as traditional Chinese medicine(TCM) symptom scores,memory function [Wechsler Memory Scale-Revised in China(WMS-RC)],cognitive function [MATRICS Consensus Cognitive Battery(MCCB)],and serum factor indicators [Neural Cell Adhesion Molecule(NCAM),Catechol-O-Methyltransferase(COMT),Macrophage Migration Inhibitory Factor(MIF)] before and after treatment,was compared between the two groups.Adverse reactions and extrapyramidal system reactions [Simpson-Angus Scale(SAS),Barnes Akathisia Rating Scale(BARS),Abnormal Involuntary Movement Scale(AIMS)] were also compared between the two groups.Results The total effective rate in the observation group [97.96%(48/49)] was higher than that in the control group [83.67%(41/49)],with a significant difference(P<0.05).At 8 weeks after treatment,the scores for mental depression,mental dullness,chest tightness and sighing,anxiety and suspicion,and muttering or silence in the observation group were lower than those in the control group,while the WMS-RC and MCCB scores in the observation group were higher than those in the control group(P<0.05).At 8 weeks after treatment,the serum NCAM level in the observation group was higher than that in the control group,while the COMT and MIF levels were lower than those in the control group(P<0.05).There were no significant differences in the incidence and severity of adverse reactions,as well as SAS,BARS,and AIMS scores,between the two groups(P>0.05).Conclusion The combination of Modified Ditan decoction and risperidone microspheres for injection(Ⅱ) has a definite therapeutic effect on schizophrenia with phlegm-qi stagnation syndrome.It can improve clinical symptoms,enhance memory and cognitive function,alleviate disease severity,and has a certain degree of safety.
作者
谢春平
刘医农
焦英霞
XIE Chunping;LIU Yinong;JIAO Yingxia(Department of Psychiatry,the Seventh People's Hospital of Hengshui City,Hengshui,Hebei 053000,China)
出处
《临床误诊误治》
2025年第9期104-110,共7页
Clinical Misdiagnosis & Mistherapy
基金
河北省中医药管理局科研计划一般项目(2023465)。
关键词
精神分裂症
加味涤痰汤
注射用利培酮微球(Ⅱ)
韦氏记忆量表
精神分裂症认知功能成套测验共识版
神经细胞黏附分子
中医证候
锥体外系反应
Schizophrenia
Modified Ditan decoction
Risperidone microspheres for injection(Ⅱ)
Wechsler Mem⁃ory Scale
Cognitive Assessment Battery for Schizophrenia Consensus Version
Neural Cell Adhesion Molecule
Traditional Chinese Medicine Syndrome
Extrapyramidal System Response
