目的 探讨礞石滚痰丸联合氨磺必利治疗精神分裂症的临床疗效及其对血清炎性、神经因子的影响。方法 选取2023年6月—2025年7月开滦总医院精神科收治的精神分裂症患者68例，随机分为对照组和治疗组，每组各34例。对照组口服氨磺必利片，0.2 g/次，1次/d。在对照组的基础上，治疗组口服礞石滚痰丸，6 g/次，1次/d。两组连服1个月。观察两组患者临床疗效，比较两组阴性和阳性症状量表（PANSS）、精神分裂症认知功能简明量表（BACS）、匹兹堡睡眠质量指数量表（PSQI）、血清神经细胞黏附分子（NCAM）、血清瞬时受体电位通道1（TRPC1）、神经轴突导向因子（Netrin-1）、神经营养因子3（NT-3）、髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）、中枢神经特异蛋白（S100B）水平。结果 治疗后，治疗组总有效率明显高于对照组（94.12% vs 73.53%，P＜0.05）。治疗后，两组患者PANSS评分和PSQI评分与治疗前比较均降低，而BACS评分高于治疗前（P＜0.05），且治疗组患者评分明显好于对照组（P＜0.05）。治疗后，两组患者NT-3水平较治疗前均明显上升，而MBP、NSE、S100B水平较治疗前降低（P＜0.05），且治疗组NT-3、MBP、NSE和S100B水平明显好于对照组（P＜0.05）。治疗后，两组患者NCAM、TRPC1、Netrin-1水平均低于同组治疗前，且治疗组NCAM、TRPC1、Netrin-1水平明显低于对照组（P＜0.05）。结论 礞石滚痰丸与氨磺必利协同治疗精神分裂症疗效显著，能显著改善患者睡眠与认知状况，并有效调节炎性因子和神经因子水平，且药物安全，值得借鉴。

Objective To investigate the clinical efficacy of Mengshi Guntan Pills combined with amisulpride in the treatment of schizophrenia and their effects on serum inflammatory and neurotrophic factors.Methods A total of 68 patients with schizophrenia admitted to the Department of Psychiatry, Kailuan General Hospital from June 2023 to July 2025 were enrolled and randomly divided into a control group and a treatment group, with 34 cases in each group. The control group received oral Amisulpride Tablets at 0.2 g once daily. On the basis of the control regimen, the treatment group was additionally given oral Mengshi Guntan Pills at 6 g once daily. Both groups were treated continuously for one month. The clinical efficacy was evaluated. The Positive and Negative Syndrome Scale (PANSS), Brief Assessment of Cognition in Schizophrenia (BACS) and Pittsburgh Sleep Quality Index (PSQI) scores were compared between two groups. Serum levels of neural cell adhesion molecule (NCAM), transient receptor potential canonical 1 (TRPC1), netrin-1, neurotrophin-3 (NT-3), myelin basic protein (MBP), neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B) were also detected and compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (94.12% vs 73.53%, P < 0.05). In both groups, PANSS and PSQI scores decreased, while BACS scores increased after treatment (P < 0.05), and the treatment group achieved better results in all these scales (P < 0.05). The serum level of NT-3 was significantly elevated, whereas the levels of MBP, NSE and S100B were decreased in both groups (P < 0.05), with more favorable changes observed in the treatment group (P < 0.05). After treatment, the levels of NCAM, TRPC1, and Netrin-1 in both groups were lower than those before treatment in same group, and the levels of NCAM, TRPC1 and Netrin-1 in treatment group were significantly lower than those in control group (P < 0.05).. Conclusion The combined therapy of Mengshi Guntan Pills and amisulpride exerts a remarkable synergistic effect on schizophrenia. It can effectively improve patients’ sleep quality and cognitive function, and regulate serum inflammatory and neurotrophic factors. This combined regimen is safe and worthy of clinical promotion.

R971

河北省医学科学研究课题（20201278）