| 王维丽,邓丽,王虹郁,杨世昌,崔桂梅.增液承气汤加减联合奥氮平治疗阳明腑实型精神分裂症的效果[J].四川精神卫生杂志,2024,37(5):403-408.Wang Weili,Deng Li,Wang Hongyu,Yang Shichang,Cui Guimei,Efficacy of Zengye Chengqi decoction combined with olanzapine in the treatment of schizophrenia of Yangming Fushi syndrome[J].SICHUAN MENTAL HEALTH,2024,37(5):403-408 |
| 增液承气汤加减联合奥氮平治疗阳明腑实型精神分裂症的效果 |
| Efficacy of Zengye Chengqi decoction combined with olanzapine in the treatment of schizophrenia of Yangming Fushi syndrome |
| 投稿时间：2024-02-20 |
| DOI：10.11886/scjsws20240220002 |
| 中文关键词: 增液承气汤加减 奥氮平 精神分裂症 阳明腑实型 事件相关电位P300 |
| 英文关键词:Zengye Chengqi decoction Olanzapine Schizophrenia Yangming Fushi syndrome Event-related potential P300 |
| 基金项目:新乡医学院第二附属医院精神神经开放课题项目（项目名称：增液承气汤加减治疗精神分裂症阳明腑实型临床评价及其作用机制的网络药理学研究，项目编号：XYEFYJSSJ-2023-09） |
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| 中文摘要: |
| 背景 阳明腑实型精神分裂症患者症状较重，抗精神病药物的治疗效果有限且副反应较大。目前，缺乏增液承气汤治疗阳明腑实型精神分裂症的临床研究。目的 探讨增液承气汤加减联合奥氮平治疗阳明腑实型精神分裂症的效果，以期为精神分裂症的中西医结合治疗提供参考。方法 选取2022年1月—2023年8月于新乡医学院第二附属医院治疗的、符合《国际疾病分类（第10版）》（ICD-10）精神分裂症诊断标准的阳明腑实型患者60例，采用随机数字表法分为研究组和对照组各30例。两组均接受奥氮平治疗，研究组在此基础上联合增液承气汤加减治疗，两组均治疗4周。在基线期及治疗后，使用阳性和阴性症状量表（PANSS）、蒙特利尔认知评估量表（MoCA）及事件相关电位P300评定，并于治疗后记录不良反应发生情况。结果 研究组治疗总有效率高于对照组（χ2=9.320，P=0.002）；治疗后，研究组PANSS各分量表评分及总评分均低于对照组，差异均有统计学意义（F=10.287、8.258、8.844、20.079，P均<0.01）；研究组MoCA延迟回忆和定向力评分均高于对照组，差异均有统计学意义（F=4.463、22.255，P<0.05或0.01）；研究组事件相关电位P300中P3波幅高于对照组，差异有统计学意义（F=4.247，P<0.05）；研究组肝功能异常、便秘、体质量指数（BMI）增加的发生率均低于对照组，差异均有统计学意义（χ2=4.320、4.463、7.200，P<0.05或0.01）。结论 增液承气汤加减联合奥氮平治疗可能有助于改善阳明腑实型精神分裂症患者的精神病性症状及认知功能，且安全性较好。 |
| 英文摘要: |
| Background Patients with schizophrenia of Yangming Fushi syndrome experience more severe symptoms， and a substantial proportion of patients derive inadequate benefit from antipsychotics and suffer from serious adverse effects， yet few studies have been conducted on the treatment of schizophrenia of Yangming Fushi syndrome with Zengye Chengqi decoction.Objective To explore the efficacy of Zengye Chengqi decoction combined with olanzapine in the treatment of schizophrenia of Yangming Fushi syndrome， in order to provide references for the treatment of schizophrenia with the combination of traditional Chinese and western medicine.Methods A total of 60 patients attending the Second Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2023 and fulfilling the International Classification of Diseases （ICD-10） diagnostic criteria for schizophrenia were enrolled， and assigned into study group （n=30） and control group （n=30） using random number table methods. All patients were treated with olanzapine， and study group was given Zengye Chengqi decoction on this basis. Treatment for both groups lasted for 4 weeks. All participants were assessed using Positive and Negative Syndrome Scale （PANSS）， Montreal Cognitive Assessment （MoCA） and Event-Related Potential P300 at baseline and end of treatment. The occurrence of adverse reactions was recorded at the end of treatment.Results Study group reported a higher treatment effective rate compared with control group （χ2=9.320， P=0.002）. After treatment， study group detected a significant reduction in PANSS subscales and total scores （F=10.287， 8.258， 8.844， 20.079， P<0.01）， and a notable increase in scores of delayed recall and orientation domains from MoCA （F=4.463， 22.255， P<0.05 or 0.01） when compared with control group， with statistical difference. For the P3 component of event-related potential， study group produced significantly larger amplitudes than control group （F=4.247， P<0.05）. The incidence rate of abnormal liver function， constipation and increased body mass index （BMI） in study group was lower than those in control group （χ2=4.320， 4.463， 7.200， P<0.05 or 0.01）.Conclusion Zengye Chengqi decoction combined with olanzapine are found to be effective in improving the psychotic symptoms and cognitive function and alleviating the adverse reactions of patients with schizophrenia of Yangming Fushi syndrome. ［Funded by Open Project of Psychiatry and Neuroscience Discipline of Second Affiliated Hospital of Xinxiang Medical College （number， XYEFYJSSJ-2023-09）； www.chictr.org.cn number： ChiCTR2200057743］ |
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