柴胡加龙骨牡蛎汤治疗抗精神病药物致高泌乳素血症的临床疗效

Clinical Effect of Radix Bupleuri-keel-oyster Soup in Treatment of High Prolactin Induced by Antipsychotic Drugs

目的探讨柴胡加龙骨牡蛎汤治疗抗精神病药物致高泌乳素血症的临床疗效。方法选取2012年12月至2014年12月唐山市第五医院收治的抗精神病药物致高泌乳素血症患者86例,采用随机数字法分为对照组和观察组,各43例。对照组采用溴隐亭治疗,开始口服每次1.25 mg,每日2次,3 d后加剂量,每次2.5 mg,每日2次,用药6个月;观察组采用柴胡加龙骨牡蛎汤治疗,每日1剂,加水300 mL,煎汁100 mL,复煎100 mL,分早晚两次服用,用药6个月。比较两组患者的临床疗效。结果观察组患者治疗后总有效率显著高于对照组[95.3%(41/43)比79.1%(34/43)](P<0.05)。两组患者治疗后1、3、6个月阳性和阴性症状评分[对照组:(68.9±3.2)分、(66.4±2.9)分、(61.2±3.7)分比(72.5±4.8)分;(60.1±3.4)分、(56.2±2.3)分、(50.3±1.8)分比(72.3±4.0)分]、临床总体印象量表-疾病严重程度分量表量表评分[对照组:(3.8±0.7)分、(3.1±0.5)分、(2.6±0.7)分比(4.5±0.3)分;(3.1±0.6)分、(2.5±0.4)分、(1.9±0.6)分比(4.4±0.5)分]、血清泌乳素均较治疗前呈下降趋势[对照组:(52.3±6.0)μg/L、(47.2±4.8)μg/L、(40.6±3.9)μg/L比(58.4±7.9)μg/L;观察组:(46.8±5.1)μg/L、(39.3±4.6)μg/L、(32.8±2.5)μg/L比(58.1±6.5)μg/L],其中观察组下降速度更快,两组在组间、时点间、组间·时点间比较差异有统计学意义(P<0.05)。观察组不良反应发生率显著低于对照组[2.3%(1/43)比18.6%(8/43)](P<0.05)。结论柴胡加龙骨牡蛎汤治疗抗精神病药物致高泌乳素血症的疗效显著,值得临床推广使用。

Objective To investigate the clinical effect of radix bupleuri-keel-oyster soup in treatment of high prolactin induced by antipsychotic drugs. Methods A total of 86 patients with high prolaetin induced by antipsychotic drugs in Tan- gshan Fifth Hospital from Dee. 2012 to Dec. 2014 were included in the study,and divided into a control group and an obser- vation group according to the random number method,43 patients each. The control group was treated with bromocriptine （ oral 1.25 mg/time, 2 times/d at first, increased to 2.5 mg/time,2 times/d after 3 d, medication for 6 months） ; the observation group was treated with radix bupleuri-keel-oyster soup （ 1 agent added into 300 mL water fried to 100 mL, and re-fried 100 mL,taken in the morning and evening,medication for 6 months）. The therapeutic effect of the two groups was compared. Results Total effective rate of the observation group was higher than the control group [ 95.3% （41/43） vs 79. 1% （34/43） ] （P 〈 0. 05）. Compared with before treatment, after 1,3,6 months of treatment the positive and negative syndrome scales of the two groups [ control group ： （68.9±3.2）, （66.4 ± 2.9）, （61.2 ± 3.7 ） vs （72.5 ± 4. 8 ） ; （60. 1 ± 3.4）, （56. 2 ± 2.3 ）, （50. 3 ± 1.8 ） vs （ 72. 3 ± 4. 0 ） ], clinical global impression--severity of illness [ control group ： （3.8±0.7）,（3. 1 ±0.5）,（2.6±0.7） vs （4.5 ±0.3）;observation group：（3. 1 ±0.6）,（2.5_±0.4）,（1.9±0.6） vs （ 4.4 ± 0. 5 ） ], serum prolactin decreased [ control group ： （ 52.3 ± 6. 0 ） p±g/L, （47.2 ± 4. 8 ） μg/L, （40.6 ± 3.9 ） μg/L vs （58.4 ± 7.9 ） μ/L; observation group ： （ 46. 8 ± 5.1 ） μg/L, （ 39. 3 ± 4. 6 ） μg/L, （ 32. 8 ± 2.5 ） Ixg/L vs （ 58. 1 ±6. 5） p±g/L]. The observation group decreased faster. There were significant differences between the groups, time points, group ± time points（P 〈 0. 05 ）. The incidence of adverse reactions in the observation group was significantly lower than the control group[2.3% （1/43） vs 18.6% （8/43） ] （P 〈 0. 05）. Conclusion Radix bupleuri-keel-oyster soup has significant effect in the treatment of high prolactin induced by antipsychotic drugs,which is worthy of the clinical application.