清心滚痰丸联合齐拉西酮治疗精神分裂症的临床研究

目的探讨清心滚痰丸联合盐酸齐拉西酮片治疗精神分裂症的临床疗效。方法选取2017年2月—2018年2月在青岛市精神卫生中心进行治疗的90例精神分裂症患者作为研究对象,根据用药差别将患者分为对照组(45例)和治疗组(45例)。对照组口服盐酸齐拉西酮片,初始剂量20 mg/次,2次/d,视病情可增至80 mg/次,2次/d,待病情稳定后20 mg/次,2次/d维持治疗。治疗组在对照组治疗的基础上口服清心滚痰丸,6 g/次,1次/d。两组均治疗8周。观察两组的临床疗效,比较两组患者治疗前后的相关评分、神经营养因子和脂肪因子水平。结果治疗后,对照组和治疗组的总有效率分别为80.00%、95.56%,两组比较差异具有统计学意义(P0.05)。治疗后,两组阴性与阳性症状量表(PANSS)评分明显降低,简易智力状态检查量表(MMSE)评分、生活质量综合评定问卷(GQOLI-74)评分、个人和社会功能量表(PSP)评分均明显升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组相关评分显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清神经元特异性烯醇化酶(NSE)、碱性髓鞘蛋白(MBP)水平均明显降低,神经营养素-3(NT-3)、脑源性神经营养因子(BDNF)、胶质细胞系来源神经营养因子(GDNF)水平均明显升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组神经营养因子水平显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清瘦素(LEP)、激素结合蛋白(SHBG)和视黄醇结合蛋白4(RBP4)水平均明显降低,脂联素(APN)水平明显均升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组脂肪因子水平显著优于对照组,两组比较差异具有统计学意义(P0.05)。结论清心滚痰丸联合盐酸齐拉西酮片治疗精神分裂症可有效改善患者阳性和阴性症状,改善患者神经功能,降低机体脂肪细胞因子水平,减少不良反应发生,具有一定的临床应用价值。

Clinical study on Qingxin Guntan Pills combined with Ziprasidone in treatment of schizophrenia

Objective To investigate the clinical efficacy of Qingxin Guntan Pills combined with Ziprasidone Hydrochloride Tablets in treatment of schizophrenia. Methods Patients (90 cases) with schizophrenia in Qingdao Mental Health Center from February 2017 to February 2018 were divided into control (45 cases) and treatment (45 cases) groups according to the difference of medication. Patients in the control group were po administered with Ziprasidone Hydrochloride Tablets, and the starting dosage was 20 mg/time, twice daily, then increased to 80 mg/time according to the condition, twice daily, and 20 mg/time for maintaining treatment after stable condition, twice daily. Patients in the treatment group were po administered with Qingxin Guntan Pills on the basis of the control group, 6 g/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the correlation scores, neurotrophic factors levels, and adipose factor levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.00% and 95.56%, respectively, and there were differences between two groups (P<0.05). After treatment, the PANSS scores in two groups were significantly decreased, but MMSE scores, GQOLI-74 scores, and PSP scores were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, these scores in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, NSE and MBP levels in two groups were significantly decreased, but NT-3, BDNF, and GDNF in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the neurotrophic factors levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, LEP, SHBG, and RBP4 levels in two groups were significantly decreased, but APN levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the adipose factor levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Qingxin Guntan Pills combined with Ziprasidone Hydrochloride Tablets can effectively improve the positive and negative symptoms of patients, improve the neurological function, decrease adipose factor levels, and reduce the occurrence of adverse reactions, which has a certain clinical application value.