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[摘要]
目的 探讨牛黄宁宫片联合阿立哌唑治疗老年精神分裂症的临床疗效。方法 选取恩施州优抚医院2015年8月-2017年11月收治的老年精神分裂症患者114例,随机分成对照组和治疗组,每组各57例。对照组患者口服阿立哌唑片,第1周5 mg/d,第2周10 mg/d,之后根据疗效和耐受情况增加剂量为15 mg/d,最大剂量不超过30 mg/d,1次/d。治疗组在对照组的基础上口服牛黄宁宫片,5片/次,3次/d。两组患者均连续治疗8周。观察两组患者临床疗效,同时比较治疗前后两组患者PANSS评分、社会认知功能、神经认知功能和血清细胞因子水平。结果 治疗后,对照组的总有效率为75.44%,显著低于治疗组的94.74%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组PANSS各项评分、PSP总分及4个维度的社会关系、有益活动、自我照料和攻击性评分均显著降低(P<0.05),且治疗后治疗组上述评分明显低于对照组(P<0.05)。治疗后,两组血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、白细胞介素-2(IL-2)和IL-6水平明显降低(P<0.05),且治疗后治疗组血清细胞因子水平明显低于对照组(P<0.05)。治疗后,两组神经认知功能明显升高(P<0.05),且治疗后治疗组神经认知功能明显高于对照组(P<0.05)。结论 牛黄宁宫片联合阿立哌唑治疗老年精神分裂症疗效确切,可有效改善血清BDNF、NGF等细胞因子水平,促进患者认知功能恢复。
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[Abstract]
Objective To explore the clinical efficacy of Niuhuang Ninggong Tablets combined with aripiprazole in treatment of senile schizophrenia. Methods Patients (114 cases) with senile schizophrenia in Enshi Special Care Hospital from August 2015 to November 2017 were randomly divided into control and treatment groups, and each group had 57 cases. Patients in the control group were po administered with Aripiprazole Tablets, 5 mg/d for the 1st week, and 10 mg/d for the 2nd week, then 15 mg/d was increased according to the patient condition, and the maximum dose was less than 30 mg/d, once daily. Patients in the treatment group were po administered with Niuhuang Ninggong Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the PANSS scores, social cognitive function, neurocognitive function, and serum cytokines levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 75.44%, which was significantly lower than 94.74% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the PANSS scores, PSP scores, social relations scores, beneficial activities scores, self care scores, and aggressive nature scores in two groups were significantly decreased (P < 0.05), and these scores in the treatment group after treatment were significantly lower than those in the control group (P < 0.05). After treatment, the BDNF, NGF, IL-2, and IL-6 levels in two groups were significantly decreased (P < 0.05), and the serum cytokines levels in the treatment group after treatment were significantly lower than those in the control group (P < 0.05). After treatment, the neurocognitive function in two groups was significantly increased (P < 0.05), and the neurocognitive function in the treatment group after treatment was significantly higher than that in the control group (P < 0.05). Conclusion Niuhuang Ninggong Tablets combined with aripiprazole in treatment of senile schizophrenia has obvious curative effect, can effectively improve serum BDNF and NGF levels, and promote the cognitive function recovery.
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