活血通窍汤治疗抗精神病药物所致的高催乳激素血症的临床研究

Clinical Research Kuoxue Tongqiao Decoction in the Treatment of Anti-Psychotics-Induced Hyperprolactinemia

目的探讨活血通窍汤治疗抗精神病药物所致的高催乳激素血症(Hp)的临床疗效。方法将2010年8月至2015年2月收治的104例抗精神病药物所致Hp患者,根据入院顺序平分为治疗组与对照组,各52例。对照组给予阿立哌唑联合溴隐亭治疗,治疗组在对照组治疗的基础上给予活血通窍汤。两组治疗疗程均为4周。观察两组患者治疗后临床疗效及内分泌激素[血清催乳素(PRL)]、精神症状[阳性和阴性症状量表(PANSS)评分]、不良反应情况。结果治疗后治疗组与对照组的有效率分别为98.1%和88.5%,治疗组明显高于对照组(P<0.05)。治疗组与对照组治疗后的PRL含量及PANSS评分均明显低于治疗前(P<0.05),同时治疗后治疗组的PRL、PANSS评分明显低于对照组(P<0.05),组间对比差异明显(P<0.05)。两组治疗期间治疗组便秘、失眠、头晕、嗜睡等不良反应发生情况明显少于对照组(P<0.05)。结论活血通窍汤治疗抗精神病药物所致的Hp能缓解精神症状,有效抑制PRL的表达,减少不良反应的发生,从而有利于总体疗效的提高。

Objective To explore the clinical effects of huoxue tongqiao decoction on hyperprolactinemia induced by anti-psychotics. Methods From August,2010 to February 2015,104 cases of anti-psychotics hyperprolactinemia were collected. According to the visit sequence,they were equally divided into a treatment group and a control group,52 cases in each one. In the control group,aripiprazole prazosin and bromocriptine were used in combination. In the treatment group,on the basis of the treatment as the control group,huoxue tongqiao decoction was applied. The duration of the treatment was 4 weeks in the two groups.The clinical therapeutic effects,PRL,mental state and adverse reactions were observed in the patients of the two groups after treatment. Results After treatment,the effective rates were 98. 1% and 88. 5% in the treatment group and the control group respectively. The effective rate in the treatment group was apparently higher than that in the control group（ P 〈0. 05）. After treatment,serum PRL level and PANSS score in the treatment group and the control group were all apparently lower than those before treatment（ P 〈0. 05）. After treatment,PRL level and PANSS score in the treatment group were apparently lower than those in the control group（ P〈 0. 05）,indicating the significant difference in comparison（ P 〈0. 05）. During the treatment,the incidences of adverse reactions such as constipation,insomnia,dizziness and drowsiness in the treatment groups were apparently less than those in the control group（ P 〈0. 05）. Conclusion Huoxue tongqiao decoction relieves the mental symptoms of hyperprolactinemia induced by anti-psychotics,inhibits the expression of serum PRL and reduces the incidence of adverse reactions and contributes to the improvement of overall therapeutic effects.