芍药甘草汤加减联合氯氮平治疗抗精神病药物所致高催乳素血症的疗效及对性激素的影响

Curative Efficacy of Using Modified Shaoyao Gancao Decoction Combined with Clozapine in the Treatment of Hyperprolactinemia Caused by Antipsychotic Drugs and Its Influence on Sex Hormones

目的:探讨芍药甘草汤加减联合氯氮平治疗抗精神病药物所致高催乳素血症的疗效及对性激素的影响。方法:选择2018年1月~2020年12月阜阳市第三人民医院收治的精神分裂患者60例,依据治疗方式不同分为对照组和观察组,每组30例,对照组给予氯氮平治疗,观察组给予芍药甘草汤加减联合氯氮平治疗。两组治疗共计8周。患者于治疗前及治疗8周末取患者空腹静脉血,离心分离血清后,采用电化学发光免疫分析仪测定泌乳素(PRL)、雌二醇(E2),孕酮(P)、睾酮(T)。用阳性与阴性症状量表(PANSS)评估患者精神症状。根据PANSS的减分率评定临床疗效,计算有效率。观察并记录治疗过程中出现的不良反应,计算不良反应发生率。结果:两组患者治疗后PRL和E2水平明显升高(P<0.05),同时观察组患者治疗后PRL和E2水平改善情况明显优于对照组(P<0.05),而组间和组内的P和T水平之间差异无统计学意义(P>0.05);治疗后上述分项量表评分均降低,同时观察组患者治疗后PANSS量表评分显著低于对照组,且差异均具有统计学意义(P<0.05);观察组总有效率(93.33%)明显高于对照组(73.33%),差异具有统计学意义(P=0.038)。结论:芍药甘草汤加减联合氯氮平治疗抗精神病药物所致高催乳素血症患者,通过降低其血清泌乳素水平,临床疗效较好,不良反应低,值得临床应用。

Objective: To explore the clinical efficacy of using Modified Shaoyao Gancao Decoction combined with Clozapine in the treatment of patients with schizophrenia and its influences on serum hormone levels. Methods: 60 patients with Schizophrenia who were treated in the outpatient department of traditional Chinese medicine of our hospital from January 2018 to December 2020, including 30 males and 30 females, were selected in research. According to the randomized control method, they were divided into a controlled group and an observation group, with 30 cases in each group. The controlled group was treated with Clozapine, and the observation group was treated with Modified Shaoyao Gancao Decoction combined with Clozapine. The two groups were treated for a total of 8 weeks. Before treatment and at the end of the 8^(th) week of treatment, the patient’s fasting venous blood was collected and the serum was separated by centrifugation. The electrochemiluminescence immunoassay was used to determine prolactin, estradiol, and progesterone and testosterone. The positive and negative syndrome scale was used to evaluate the mental symptoms of patients. The clinical efficacy was evaluated according to the reduction rate of PANSS, and the effective rate was calculated. Observed and recorded the adverse reactions during the treatment, and calculated the incidence of adverse reactions. Results: After treatment, the levels of PRL and E_(2) in the two groups significantly increased(P<0.05). At the same time, the improvement in the levels of PRL and E_(2) in the observation group was significantly better than that in the controlled group(P<0.05). There was no statistically significant difference between T levels(P > 0.05). After treatment, the scores of the above sub-scales were all reduced. At the same time, the PANSS scale scores of the observation group were significantly lower than those of the controlled group after treatment, and the differences were statistically significant(P<0.05). The total effective rate of the observation group was 93.33%(28/30) was significantly higher than that of the controlled group was 73.33%(22/30), the difference was not statistically significant(χ^(2)=4.320, P = 0.038). Conclusion: Using Shaoyao Gancao Decoction combined with clozapine in the treatment of patients with hyperprolactinemia caused by antipsychotic drugs, by reducing their serum prolactin level, the clinical effect is good, the adverse reactions are low, and it is worthy of clinical application.