利培酮治疗首发精神分裂症不同中医辨证分型的疗效观察

Comparison between Therapeutic Effect of Risperidone in Treating Different Traditional Chinese Medicine Syndrome Types of First-Episode Schizophrenia

目的：研究利培酮治疗首发精神分裂症不同中医辨证分型的疗效、副反应、认知改善的规律。方法：将首发精神分裂症患者按中医辨证分为痰湿内阻型，痰火内扰型及其他型，应用利培酮治疗，使用PANSS、TESS、WCST等评定工具观察疗效、副反应、认知改善情况。结果；有无火证（实火和虚火）是判断利培酮疗效的一个很重要的方面；失眠是一个较普遍出现的药物副反应，而静坐不能，在痰火内扰型出现的严重程度最大；痰湿内阻型入组前的认知功能损害较其他两组大，痰火内扰型WCST中卡片总数的减少与入组前比较有显著性差异（P＜0．05）。结论：结合中医辨证使用利培酮是提高疗效的好方法。

Objective: To study the therapeutic effect, side effects and cognize improvement of Risperidone in treating different TCM Syndrome-types of first-episode schizophrenia. Methods: Applying Risperidone to treat first episode schizophrenics who were divided into Phlegm-Dampness type, Phlegm-Fire type and other types in TCM, and observing them with PANSS, TESS and Wisconsin Card Sorting Test (WCST). Results: It is im portant to assess the therapeutic effect of patient with Fire Syndrome or without. Insomnia is the most prevalent side effect, while akathisia in Phlegm-Fire type is the most serious side effect, cognition deficiency in Phlegm Dampness type is the most serious before treatment, and reduction of total card number of WCST in Phlegm Fire type is significant after treatment (P<0. 05). Conclusion: It is the best way to use Risperidone combined with TCM Syndrome Differentiation so as to elevate the efficacy.