中药血府逐瘀汤辅助阿立哌唑治疗闭经的精神分裂症对照观察

Controlled observation of traditional Chinese medicine Xuefuzhuyu decoction combined with aripiprazole in treatment of schizophrenic patients with antipsychotic-induced amenorrhea

目的探讨中药血府逐瘀汤辅助阿立哌唑治疗闭经的精神分裂症患者临床疗效。方法将67例抗精神病药引起闭经的精神分裂症患者按分层随机分为A组（n=33）、B组（n=34）,A组中药血府逐瘀汤辅助阿立派唑治疗,B组单用阿立派唑治疗。疗程3个月。治疗基线,治疗1、2、3个月末分别测定2组患者血清催乳素（PRL）浓度,评估患者闭经疗效;治疗基线,治疗3个月末评定精神分裂症的阳性与阴性症状量表（PANSS）。结果 A组共计有效32例,月经恢复时间0.9~1.9（1.69±0.21）个月;B组共计有效33例,月经恢复时间1.4~2.8（2.05±0.36）个月。A、B组月经恢复时间比较差异有统计学意义（t=-4.843,P=0.000）。A组入组治疗3个月末闭经患者总有效率（100.00%）与B组（97.06%）比较差异无统计学意义（χ2=0.956,P=0.328）。A组治疗基线,治疗1、2、3个月末血清PRL浓度[分别为（113.88±40.84）、（43.59±17.35）、（16.88±8.42）、（15.53±6.28）μg/L]与B组血清PRL浓度[分别为（111.94±39.27）、（42.15±17.27）、（17.59±7.22）、（16.26±5.46）μg/L]比较差异无统计学意义（P〉0.05）。A组PANSS总分（45.69±13.28）显著低于B组（54.03±18.52）（t=-2.091,P=0.040）。结论中药血府逐瘀汤辅助阿立哌唑治疗闭经的精神分裂症有助患者月经的恢复,同时可提升精神分裂症的临床疗效。

Objective To study the clinical effects of Xuefuzhuyu decoction（a traditional Chinese medicine） combined with aripiprazole in the treatment of schizophrenic patients with antipsychotic-induced amenorrhea.Methods Sixty-seven schizophrenic patients with antipsychotic-induced amenorrhea were randomly divided into group A（33 patients） treated with Xuefuzhuyu decoction combined with aripiprazole,and group B（34 patients） treated with aripiprazole alone.The treatment course was 3 months.The concentrations of prolactin（PRL） in serum were measured at the beginning of the study and at the end of each month,and the clinical effects on antipsychotic-induced amenorrhea were compared.The clinical effects on schizophrenosis were assessed using Positive and Negative Syndrome Scale（PANSS） at the beginning and the end of the study.Results The differences between PRL concentrations（base line and at the end of the 1st,2nd,and 3rd months） of group A（113.88±40.84 μg/L,43.59±17.35 μg/L,16.88±8.42 μg/L and 15.53±6.28 μg/L） and group B（111.94±39.27 μg/L,42.15±17.27 μg/L,17.59±7.22 μg/L and 16.26±5.46 μg/L） had no statistical significance（t=0.196-0.600,P=0.845-0.550）.The curative rate of antipsychotic-induced amenorrhea of group A（100.00%） was not significantly different from that of group B（97.06%）（Chi square=0.956,P=0.328）.The total PANSS score of group A（45.69±13.28） was significantly lower than that of group B（54.03±18.52） at the end of the 3-month study（t=-2.091,P=0.040）.Conclusion In the treatment of schizophrenic patients with antipsychotic-induced amenorrhea,Xuefuzhuyu decoction combined with aripiprazole can help to restore menstruation and improve the curative effect on schizophrenia.