芍药当归汤辅助治疗氨磺必利所致高催乳素血症的临床疗效及对患者血清催乳激素和免疫状态的影响
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摘要
目的观察芍药当归汤辅助治疗氨磺必利所致高催乳素血症的临床疗效及对患者血清催乳激素(PRL)和免疫状态的影响。方法将85例氨磺必利所致高催乳素血症患者按照随机数字表法分为2组。2组在原氨磺必利治疗方案不变的情况下,对照组40例予甲磺酸溴隐亭治疗;观察组45例在对照组治疗基础上予芍药当归汤辅助治疗。2组均治疗8周后统计临床疗效,并观察2组治疗前及治疗2周、4周、8周血清PRL水平,治疗前后自然杀伤(NK)细胞活性、T淋巴细胞亚群(CD3~+、CD4~+、CD8~+)、血清免疫球蛋白(Ig)G、IgA、IgM及补体(C)3、C4,以及药物不良反应发生情况。结果观察组总有效率91.1%,对照组总有效率75.0%,观察组疗效优于对照组(P<0.05)。治疗2周、4周、8周后2组血清PRL均较本组治疗前下降(P<0.05),且观察组血清PRL水平均低于对照组同期(P<0.05)。治疗后2组NK细胞活性较本组治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后2组CD4~+水平较本组治疗前均升高(P<0.05),且观察组高于对照组(P<0.05);治疗后2组CD3~+、CD8~+较本组治疗前升高(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗后2组IgG、IgM及C3水平较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后2组IgA、C4组间及组内比较差异均无统计学意义(P>0.05)。2组均有头痛、便秘、静坐不能等不良反应,2组各不良反应发生率比较差异无统计学意义(P>0.05)。结论芍药当归汤辅助治疗氨磺必利所致高催乳素血症能使血清PRL快速降低,改善患者免疫功能。
Objective To observe the clinical efficacy of Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride and its effect on serum prolactin(PRL) and immune status. Methods 85 patients with hyperprolactinemia caused by amisulfapride were divided into two groups according to random number table method. In the two groups, the original amisulpride treatment regimen was unchanged. 40 patients in control group were treated by bromocriptine mesylate. 45 patients in observation group were treated by Shaoyao Danggui decoction on the basis of the control group as an adjuvant treatment. The clinical efficacy was evaluated after 8 weeks of treatment in both groups. The serum PRL levels before treatment and 2 weeks, 4 weeks, and 8 weeks after treatment were observed. The natural killer(NK) cell activity and T lymphocyte subsets(CD3~+, CD4~+, CD8~+), serum immunoglobulin(Ig)G, IgA, IgM and complement(C)3, C4, and the occurrence of adverse drug reactions before and after treatment. Results The total effective rate of the observation group was 91.1% and 75.0% in the control group. The curative effect of the observation group was better than the control group(P<0.05). After 2, 4 and 8 weeks of treatment, the serum PRL levels in the two groups were lower than those in the group before treatment(P<0.05), and the serum PRL levels in the observation group were lower than those in the control group at the same time(P<0.05). After treatment, NK cell activity in the two groups was higher than that in the group before treatment(P<0.05), and the observation group was higher than the control group(P<0.05). After treatment, the levels of CD4~+ in both groups were higher than those in the group before treatment(P<0.05), and the observation group were higher than the control group(P<0.05). After treatment, the levels of CD3~+ and CD8~+ in the two groups were higher than those in the group before treatment(P<0.05), but there was no statistically significant difference between the two groups(P>0.05). After treatment, the levels of IgG, IgM and C3 in the two groups were lower than those in the group before treatment(P<0.05), and the observation group were lower than the control group(P<0.05). After treatment, there were no statistically significant differences between the two groups of IgA, C4 or within the group(P>0.05). Both groups had adverse reactions such as headache, constipation and inability to sit still. There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride can rapidly reduce serum PRL and improve the immune function of patients.
Objective To observe the clinical efficacy of Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride and its effect on serum prolactin(PRL) and immune status. Methods 85 patients with hyperprolactinemia caused by amisulfapride were divided into two groups according to random number table method. In the two groups, the original amisulpride treatment regimen was unchanged. 40 patients in control group were treated by bromocriptine mesylate. 45 patients in observation group were treated by Shaoyao Danggui decoction on the basis of the control group as an adjuvant treatment. The clinical efficacy was evaluated after 8 weeks of treatment in both groups. The serum PRL levels before treatment and 2 weeks, 4 weeks, and 8 weeks after treatment were observed. The natural killer(NK) cell activity and T lymphocyte subsets(CD3~+, CD4~+, CD8~+), serum immunoglobulin(Ig)G, IgA, IgM and complement(C)3, C4, and the occurrence of adverse drug reactions before and after treatment. Results The total effective rate of the observation group was 91.1% and 75.0% in the control group. The curative effect of the observation group was better than the control group(P<0.05). After 2, 4 and 8 weeks of treatment, the serum PRL levels in the two groups were lower than those in the group before treatment(P<0.05), and the serum PRL levels in the observation group were lower than those in the control group at the same time(P<0.05). After treatment, NK cell activity in the two groups was higher than that in the group before treatment(P<0.05), and the observation group was higher than the control group(P<0.05). After treatment, the levels of CD4~+ in both groups were higher than those in the group before treatment(P<0.05), and the observation group were higher than the control group(P<0.05). After treatment, the levels of CD3~+ and CD8~+ in the two groups were higher than those in the group before treatment(P<0.05), but there was no statistically significant difference between the two groups(P>0.05). After treatment, the levels of IgG, IgM and C3 in the two groups were lower than those in the group before treatment(P<0.05), and the observation group were lower than the control group(P<0.05). After treatment, there were no statistically significant differences between the two groups of IgA, C4 or within the group(P>0.05). Both groups had adverse reactions such as headache, constipation and inability to sit still. There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride can rapidly reduce serum PRL and improve the immune function of patients.
引文
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[3] 姜宝顺,陈允恩,马建华.柴胡加龙骨牡蛎汤加减方治疗利培酮所致高催乳素血症的临床研究[J].中国中西医结合杂志,2018,38(10):1268-1270.
[4] 陈莉茹,吴琼,郭丽,等.桂附地黄丸治疗药物性高催乳素血症的临床效果观察[J].中药药理与临床,2017,33(3):206-208.
[5] 迟勇.氨磺必利与利培酮对女性精神分裂症患者血清催乳素的影响研究[J].中国医刊,2016,51(2):92-95.
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[7] 沙建敏,张伟,丁景景,等.男性精神分裂症患者小剂量阿立哌唑联合氨磺必利治疗对性功能、催乳素的影响[J].中国农村卫生事业管理,2017,37(3):356-358.
[8] 世界中医药学会联合会妇科专业委员会.国际中医妇科诊断标准与疗效评价标准(讨论稿)[J].天津中医药,2007,24(增刊):49-53.
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[10] 顾培,靳秀,李雪,等.芍药甘草汤治疗奥氮平所致高催乳素血症的临床研究[J].中国中西医结合杂志,2016,36(12):1456-1459.
[11] 辛宇,路甲鹏,陈迪,等.中西医结合治疗高催乳素血症临床效果meta分析[J].临床误诊误治,2014,27(5):89-93.
[12] Reeves S,Sugita E,Baldeweg SE,et al.Management of antipsychotic related hyperprolactinemia in older people:Can we extrapolate from existing guidance[J].Int J Geriatr Psychiatry,2018,33(12):1743-1744.
[13] 郑丽宏,韩闻卿,姜雅秋.高催乳素血症伴垂体腺瘤325例临床病理特点及疗效分析[J].中国实用内科杂志,2017,37(10):914-916.
[14] Hardy S,Kostantin E,Hatzihristidis T,et al.Physiological and oncogenic roles of the PRL phosphatases[J].FEBS J,2018,285(21):3886-3908.
[15] Mazher OA,Maneta E,Hall W.Treatment of Risperidone-Associated Hyperprolactinemia With Aripiprazole[J].J Clin Psychopharmacol,2018,38(5):529-531.
[16] Riera-Leal A,Ramírez De Arellano A,Ramírez-López IG,et al.Effects of 60 kDa prolactin and estradiol on metabolism and cell survival in cervical cancer:Coexpression of their hormonal receptors during cancer progression[J].Oncol Rep,2018,40(6):3781-3793.
[17] Papareddy P,Kasetty G,Alyafei S,et al.An ecoimmunological approach to study evolutionary and ancient links between coagulation,complement and Innate immunity[J].Virulence,2018,9(1):724-737.
[2] 王建红,任毅,尹建红,等.高泌乳素血症临床诊断新进展[J].中国实用神经疾病杂志,2018,21(2):230-232.
[3] 姜宝顺,陈允恩,马建华.柴胡加龙骨牡蛎汤加减方治疗利培酮所致高催乳素血症的临床研究[J].中国中西医结合杂志,2018,38(10):1268-1270.
[4] 陈莉茹,吴琼,郭丽,等.桂附地黄丸治疗药物性高催乳素血症的临床效果观察[J].中药药理与临床,2017,33(3):206-208.
[5] 迟勇.氨磺必利与利培酮对女性精神分裂症患者血清催乳素的影响研究[J].中国医刊,2016,51(2):92-95.
[6] 郑育喜,杨杰.氨磺必利对精神分裂症患者催乳素水平的影响[J].中国实用医药,2016,11(10):40-42.
[7] 沙建敏,张伟,丁景景,等.男性精神分裂症患者小剂量阿立哌唑联合氨磺必利治疗对性功能、催乳素的影响[J].中国农村卫生事业管理,2017,37(3):356-358.
[8] 世界中医药学会联合会妇科专业委员会.国际中医妇科诊断标准与疗效评价标准(讨论稿)[J].天津中医药,2007,24(增刊):49-53.
[9] 朱文玲.内科疾病诊断与疗效标准[M].上海:上海中医药大学出版社,2005:205-206.
[10] 顾培,靳秀,李雪,等.芍药甘草汤治疗奥氮平所致高催乳素血症的临床研究[J].中国中西医结合杂志,2016,36(12):1456-1459.
[11] 辛宇,路甲鹏,陈迪,等.中西医结合治疗高催乳素血症临床效果meta分析[J].临床误诊误治,2014,27(5):89-93.
[12] Reeves S,Sugita E,Baldeweg SE,et al.Management of antipsychotic related hyperprolactinemia in older people:Can we extrapolate from existing guidance[J].Int J Geriatr Psychiatry,2018,33(12):1743-1744.
[13] 郑丽宏,韩闻卿,姜雅秋.高催乳素血症伴垂体腺瘤325例临床病理特点及疗效分析[J].中国实用内科杂志,2017,37(10):914-916.
[14] Hardy S,Kostantin E,Hatzihristidis T,et al.Physiological and oncogenic roles of the PRL phosphatases[J].FEBS J,2018,285(21):3886-3908.
[15] Mazher OA,Maneta E,Hall W.Treatment of Risperidone-Associated Hyperprolactinemia With Aripiprazole[J].J Clin Psychopharmacol,2018,38(5):529-531.
[16] Riera-Leal A,Ramírez De Arellano A,Ramírez-López IG,et al.Effects of 60 kDa prolactin and estradiol on metabolism and cell survival in cervical cancer:Coexpression of their hormonal receptors during cancer progression[J].Oncol Rep,2018,40(6):3781-3793.
[17] Papareddy P,Kasetty G,Alyafei S,et al.An ecoimmunological approach to study evolutionary and ancient links between coagulation,complement and Innate immunity[J].Virulence,2018,9(1):724-737.