柴胡桃仁汤对迟发性运动障碍的治疗及可能机制

Effect of Chaihu-Taoren Tang on tardive dyskinesia and the possible mechanism

目的:评价柴胡桃仁汤对迟发性运动障碍(TD)的疗效,探索可能存在的治疗机制。方法:将80例TD患者随机分成两组,分别运用柴胡桃仁汤、安慰剂治疗,疗程12周。治疗前后,分别评定异常不自主运动量表(AIMS),评价柴胡桃仁汤对TD的疗效,并测定血浆超氧化物歧化酶(SOD)、谷胱苷肽过氧化物酶(Gpx)、过氧化氢酶(CAT)的活性及丙二醛(MDA)水平,对比治疗前后这些指标的改变。结果:柴胡桃仁汤对TD疗效显著,减分率大于50%的患者有15例,只有2例患者TD症状有一定程度的恶化;柴胡桃仁汤能够有效提高SOD[治疗前(88.9±19.2)×103U.L-1],治疗后(95.8±26.1)×103U.L-1],Gpx[治疗前(112.9±21.7)×103U.L-1,治疗后(123.1±29.6)×103U.L-1],CAT[治疗前(1.6±1.5)×103U.L-1,治疗后(3.1±2.4)×103U.L-1]的活性,显著降低血浆MDA[治疗前(14.1±7.8)mmol.L-1,治疗后(9.4±4.7)mmol.L-1]的水平(P<0.05)。结论:柴胡桃仁汤能通过降低自由基损伤而有效缓解TD症状,氧化应激在TD发生过程中起重要作用。

Objective： To evaluate the therapeutic effect of Chaihu Taoran Tang （CTT） on the AIMS scores in patients with tardive dyskinesia （TD） and the possible mechanisms. Methods： Eligible patients were randomized to receive the CTT or placebo in a double-blinded study lasting 12 weeks. The therapeutic effects were assessed by using abnormal involuntary movement scale （AIMS）. The mechanism was investigated by comparing the activities of plasma superoxide dismutase （SOD） , catalase （CAT） and glutathione peroxidase （Gpx） as well as maleic dialdehyde （MDA） level before and after the treatment. Results ： CTT effectively reduced the severity of dyskinesia; the AIMS scores decreased over 50% in 15 patients while only 2 patients got worse in CTT group. CTT increased the activities of SOD[ from baseline （88.9 ±19.2） to （95.8±26.1）×10^3 U·L^-1, Gpx[ from （112.9±21.7） to （123.1±29.6）×10^3 U·L^-1] and CAT[from （1.6±1.5） to （3.1±2.4）×10^3 U·L^-1], and decreased the level of MDA [ from baseline （ 14.1±7.8 ） to （ 9.4± 4.7 ） mmol·L^-1] significantly （ P 〈 0.05 ）. Conclusion ： CTT, a prescription of traditional Chinese Medicine, is markedly effective in reducing the severity of dyskinesia in TD patients, and the oxidative damage might be pathophysiological key factor of TD.