芪参复康胶囊、丁螺环酮对焦虑症患者事件相关电位P300的影响

Comparison of event- related potentials P300 change in patients with anxiety disorder and treated with Qishen Fukang capsules or Buspirone

目的评价芪参复康胶囊、丁螺环酮对焦虑症患者认知功能的影响。方法将本院70例焦虑症患者按随机数字表法分两组，中药组（35例）给予芪参复康胶囊，西药组（35例）给予丁螺环酮。两组患者于治疗前、治疗后6周进行HAMA评定及P300检查，另选36名健康志愿者（对照组）行P300检查。分析两组患者治疗前后对认知功能的影响。结果（1）与治疗前相比，治疗后HAMA评分中药组[（27．4±5．4）分vs．（5．2±2．2）分]和西药组[（27．2±6．2）分vs．（6．7±2．6）分]均降低（P〈0．05），且中药组HAMA减分率高于西药组[（80．7土4．5）％vs．（75．4±5．1）％，P〈0．053。（2）与治疗前相比，两组治疗后P3潜伏期均缩短[中药组：（382．1±76．8）msvs．（292．1±70．4）ms，P〈0．05；西药组：（384．6±73．6）msvs．（323．6±61.1）ms，P〈0．053，N2、P3波幅均升高[中药组：N2（3．6±1．7）μVvs．（5．8±2．1）μV，P3（6．2±2．3）μVvs．（9．8±2．2）μV，P〈0．05；西药组：N2（3．5±1．6）μVvs．（4．o±1．4）μV，P3（6．3±2．1）μVvs．（7．8±2．7）μV，P〈0．053。（3）与对照组相比，治疗前中药组、西药组P3潜伏期均延迟，N2、P3波幅均降低（P〈0．05）；治疗后中药组P3潜伏期及N2、P3波幅差异无统计学意义（P〉0．05），西药组P3潜伏期及N2、P3波幅仍偏低（P〈0．05）。结论芪参复康胶囊、丁螺环酮治疗均可缓解焦虑症临床症状及改善其认知功能，而芪参复康胶囊提高患者信息加工的感知觉识别与编码的疗效优于丁螺环酮。

Objective To compare the effects of Qishen Fukang capsules and Buspirone on cogni- tive function in anxiety disorders. Methods 70 patients with anxiety disorders from Center for Mental Disease Control and Prevention of Third Hospital of PLA were enrolled as research group. The research group was divided into Qishen Fukang capsules treated group （Chinese medicine group, CMG, 35 cases） and Buspirone treated group （Western medicine group, WMG, 35 cases） by the method of the random number table. The research groups were assessed with the Hamilton Anxiety Scale （HAMA） and meas- ured with evoked event--related potential P300 change before and after 6 weeks treatment. Another 36 healthy subjects were involved as controls and they were given simultaneously the same tests. The effect of Qishen Fukang capsules and Buspirone on cognitive function in anxiety disorder before and after treat- ment was compared. Results （1） Comparing to prior-- treatment [CMG （27.4±5.4） score vs. WMG （27.2±6.2） score], the HAMD scores of patients [CMG （5.2±2. 2） score vs. WMG （6.7±2.6） score] were decreased significantly （P〈0.05） post--treatment. The CMG in HAMD scores were signif- icantly lower than the WMG （P〈0.05）. The HAMD reductive rate in CMG was significantly higher than the WMG [（80.7±4.5）% vs. （75.4±5.1）%, P〈0.05]. （2） Comparing to prior--treatment, the latency were shortened [CMG： （382.1 ± 76.8）ms vs. （292. 1 ± 70.4）ms; WMG： （384.6 ± 73.6）ms vs. （323.6±61.1）ms] while the amplitudes were prolonged [CMG： N2（3.6±1.7）μV vs. （5.8±2.1） μV, P3（6.2±2.3）μVvs. （9.8±2.2）μV; WMG： N2（3.5±1. 6）μV vs. （4.0±1.4）μV, P3（6.3± 2.1）μV vs. （7.8±2.7）μV] post treatment （all P values〈0.05）. （3） Comparing to the controls, the P3 latency were longer while the N2, P3 amplitudes were lower prior--treatment, and the P3 latency were shortened, while the N2, P3 amplitudes were prolonged in the CMG and WMG post--treatment （all P〈0.05）. The latency and amplitudes of N2, P3 were no difference in the CMG （all P〉0.05） while the P3 latency was still longer and the N2, P3 amplitudes were still significantly lower （all P〈0.05） in the WMG post-- treatment. Conclusions Qishen Fukang capsules and Fluoxetine can improve significantly clinical symptoms and cognitive function in anxiety disorders. Qishen Fukang capsule is superior to Buspirone on improving information processing, recognition, and coding of sensation and per- ception.