疏肝解郁胶囊联合阿立哌唑治疗精神分裂症的疗效及对脑损伤标志物水平的影响研究
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摘要
目的探讨疏肝解郁胶囊联合阿立哌唑治疗精神分裂症的疗效及对血清神经元特异性烯醇化酶(NSE)、S100β钙结合蛋白(S100β)及脑源性神经营养因子(BDNF)水平的影响。方法选择医院2015年1月至2017年12月收治的精神分裂症患者97例,随机分为对照组(48例)和治疗组(49例)。对照组患者给予阿立哌唑治疗,治疗组患者加用疏肝解郁胶囊治疗,两组均连续治疗2个月。结果治疗组总有效率为95. 92%,明显高于对照组的75. 00%(χ~2=8. 591,P=0. 003 <0. 01);治疗后,两组患者匹兹堡睡眠质量指数(PSQI)及简明精神病评定量表(BPRS)评分均明显降低(P <0. 05),且治疗组明显低于对照组(P <0. 05);治疗后,两组患者血清S100β及NSE水平均明显降低,血清BDNF水平明显升高,且治疗组变化均优于对照组(P <0. 05);两组治疗过程中的不良反应发生率相当(10. 42%比12. 24%,χ2=0. 081,P=0. 777> 0. 05)。结论疏肝解郁胶囊联合阿立哌唑治疗精神分裂症临床疗效显著,能提高睡眠质量和精神状态,改善血清NSE,S100β,BDNF水平,且安全性较好,值得临床推广。
Objective To investigate the clinical efficacy of Shugan Jieyu Capsules combined with aripiprazole in the treatment of schizophrenia and its effect on the levels of serum neuron specific enolase( NSE),S100β calcium binding protein( S100β) and brain-derived neurotrophic factor( BDNF). Methods Totally 97 patients with schizophrenia admitted to our hospital from January 2015 to December 2017 were selected and randomly divided into the control group( 48 cases) and the treatment group( 49 cases). The control group was treated with aripiprazole,while the treatment group was treated with Shugan Jieyu Capsules combined with aripiprazole. The two groups were treated for 2 months. Results The total effective rate of the treatment group was 95. 92%,which was significantly higher than 75. 00% of the control group( χ2 = 8. 591,P = 0. 003 < 0. 01). After treatment,the scores of PSQI and BPRS in the two groups were significantly decreased( P < 0. 05),and those in the treatment group were significantly lower than those in the control group( P < 0. 05). After treatment,the levels of serum S100β and NSE in the two groups were significantly decreased,while the levels of serum BDNF in the two groups were significantly increased,and the change in the treatment group was better than that in the control group( P < 0. 05). The incidence rate of adverse reactions in the two groups was similar( 10. 42% vs. 12. 24%,χ2 = 0. 081,P =0. 777 > 0. 05). Conclusion Shugan Jieyu Capsules combined with aripiprazole in the treatment of schizophrenia have significant clinical effect and safety,they can improve sleep quality and mental state,improve the levels of serum NSE,S100β and BDNF,which are worthy of clinical promotion.
Objective To investigate the clinical efficacy of Shugan Jieyu Capsules combined with aripiprazole in the treatment of schizophrenia and its effect on the levels of serum neuron specific enolase( NSE),S100β calcium binding protein( S100β) and brain-derived neurotrophic factor( BDNF). Methods Totally 97 patients with schizophrenia admitted to our hospital from January 2015 to December 2017 were selected and randomly divided into the control group( 48 cases) and the treatment group( 49 cases). The control group was treated with aripiprazole,while the treatment group was treated with Shugan Jieyu Capsules combined with aripiprazole. The two groups were treated for 2 months. Results The total effective rate of the treatment group was 95. 92%,which was significantly higher than 75. 00% of the control group( χ2 = 8. 591,P = 0. 003 < 0. 01). After treatment,the scores of PSQI and BPRS in the two groups were significantly decreased( P < 0. 05),and those in the treatment group were significantly lower than those in the control group( P < 0. 05). After treatment,the levels of serum S100β and NSE in the two groups were significantly decreased,while the levels of serum BDNF in the two groups were significantly increased,and the change in the treatment group was better than that in the control group( P < 0. 05). The incidence rate of adverse reactions in the two groups was similar( 10. 42% vs. 12. 24%,χ2 = 0. 081,P =0. 777 > 0. 05). Conclusion Shugan Jieyu Capsules combined with aripiprazole in the treatment of schizophrenia have significant clinical effect and safety,they can improve sleep quality and mental state,improve the levels of serum NSE,S100β and BDNF,which are worthy of clinical promotion.
引文
[1]袁春.精神分裂症治疗依从性研究进展[J].基层医学论坛,2017,21(29):4051-4052.
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[3]杨飞瀑,何洋,王震,等.抗精神分裂症药物研究进展[J].药学学报,2016,51(12):1809-1821.
[4]张胜利.阿立哌唑与利培酮治疗精神分裂症的疗效比较[J].现代诊断与治疗,2017,28(19):3563-3564.
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[13]陈璇,张宏耕,宋炜熙.精神分裂症的中医证候规律研究[J].湖南中医杂志,2016,32(9):1-5.
[14]周元甲.舒肝解郁胶囊联合阿立哌唑对精神分裂症患者认知功能的影响[J].中医临床研究,2017,9(6):17-18.
[15]李刚.舒肝解郁胶囊联合阿立哌唑治疗老年精神分裂症阴性症状的临床研究[J].中国医药科学,2014,4(1):96-130.
[16]杨润康.舒肝解郁胶囊联合阿立哌唑治疗老年精神分裂症阴性症状26例[J].中国中医药现代远程教育,2013,11(5):39-40.
[17]王效德,郭素香. NSE、S100B蛋白在CNS损伤中的研究进展[J].中国现代医药杂志,2011,13(9):121-124.
[18]陈兴阳,许德河,贾方增,等.阿立哌唑对精神分裂症患者血清神经元特异性烯醇化酶、S100B蛋白和髓鞘碱性蛋白水平的影响及疗效观察[J].中国现代医生,2017,55(33):1-4.
[19]孙萌萌,刘兰芬.脑源性神经营养因子BDNF与精神分裂症的关联性研究进展[J].精神医学杂志,2011,24(5):392-394.
[20]陈嘉,黄海燕,周伟东,等.疏肝解郁胶囊对精神分裂症合并长期失眠患者的睡眠指数和精神状态的影响[J].国际精神病学杂志,2017,44(6):1038-1044.
[2]孙志刚,王学义.精神分裂症认知功能缺陷的药物治疗研究进展[J].临床精神医学杂志,2017,27(2):140-142.
[3]杨飞瀑,何洋,王震,等.抗精神分裂症药物研究进展[J].药学学报,2016,51(12):1809-1821.
[4]张胜利.阿立哌唑与利培酮治疗精神分裂症的疗效比较[J].现代诊断与治疗,2017,28(19):3563-3564.
[5]王孝阳,林天凑,沈鑫华.舒肝解郁胶囊治疗精神分裂症临床研究[J].新中医,2015,47(12):35-37.
[6]中华医学会精神科分会.中国精神障碍诊断与分类标准[M].第3版.济南:山东科学技术出版社,2001:75-76.
[7]张平,杜文海.匹兹堡睡眠质量指数的实际应用[J].疾病控制杂志,2001,5(4):318-320.
[8]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1993:198-206.
[9]沈渔.精神病学[M].第4版.北京:人民卫生出版社,2003:197-198.
[10]毛稚霞.舌诊在精神疾病诊断中的研究现状[J].国际中医中药杂志,2010,32(3):279-280.
[11]王云香.精神分裂症患者血清BDNF、GDNF水平与认知功能的改变及抗精神药物和物理治疗对其的影响[J].中国健康心理学杂志,2017,25(10):1457-1460.
[12]梁立侠.阿立哌唑与喹硫平治疗精神分裂症的疗效与安全性[J].世界最新医学信息文摘,2017,17(79):80.
[13]陈璇,张宏耕,宋炜熙.精神分裂症的中医证候规律研究[J].湖南中医杂志,2016,32(9):1-5.
[14]周元甲.舒肝解郁胶囊联合阿立哌唑对精神分裂症患者认知功能的影响[J].中医临床研究,2017,9(6):17-18.
[15]李刚.舒肝解郁胶囊联合阿立哌唑治疗老年精神分裂症阴性症状的临床研究[J].中国医药科学,2014,4(1):96-130.
[16]杨润康.舒肝解郁胶囊联合阿立哌唑治疗老年精神分裂症阴性症状26例[J].中国中医药现代远程教育,2013,11(5):39-40.
[17]王效德,郭素香. NSE、S100B蛋白在CNS损伤中的研究进展[J].中国现代医药杂志,2011,13(9):121-124.
[18]陈兴阳,许德河,贾方增,等.阿立哌唑对精神分裂症患者血清神经元特异性烯醇化酶、S100B蛋白和髓鞘碱性蛋白水平的影响及疗效观察[J].中国现代医生,2017,55(33):1-4.
[19]孙萌萌,刘兰芬.脑源性神经营养因子BDNF与精神分裂症的关联性研究进展[J].精神医学杂志,2011,24(5):392-394.
[20]陈嘉,黄海燕,周伟东,等.疏肝解郁胶囊对精神分裂症合并长期失眠患者的睡眠指数和精神状态的影响[J].国际精神病学杂志,2017,44(6):1038-1044.