补阳还五汤治疗Ⅱ型精神分裂症患者的随机双盲对照研究

Randomized double-blind control study on the efficacy of Buyang Huanwu decoction in the treatment of type Ⅱ schizophrenia

目的观察补阳还五汤对Ⅱ型精神分裂症患者的疗效。方法将Ⅱ型精神分裂症患者随机分为中药组和西药组,西药组给予阿立哌唑治疗,中药组在阿立哌唑治疗的同时服用补阳还五汤。用阳性和阴性症状量表(PANSS量表)、血清脑源性神经营养因子(BDNF)、威斯康星卡片分类测验(WCST)软件系统在患者入组时、第6周末评估其精神症状和认知功能。结果到达观测点中药组33例,西药组34例。中药组总显效率39.39%,西药组总显效率17.65%,差异有统计学意义(P <0.05)。中药组与西药组第6周末PANSS总分均低于入组时,差异有统计学意义(P <0.01),中药组第6周末PANSS总分低于西药组,差异有统计学意义(P <0.05);中药组第6周末的血清BDNF水平高于入组时,差异有统计学意义(P <0.05);以正常值高限为基线,入组时WCST结果 2组错误应答数、持续应答数、非持续性错误与基线比较差异均有统计学意义(P <0.05),第6周末WCST结果显示西药组持续应答数以及中药组错误应答数、持续应答数均改善,与基线比较差异无统计学意义。结论补阳还五汤能进一步改善Ⅱ型精神分裂症患者的精神症状,升高血清BNDF,减轻患者的认知缺陷,加强疗效,可用于精神分裂症的辅助治疗。

Objective To measure the curative effect of Buyang Huanwu decoction on type Ⅱ schizophrenia.Methods Patients with typeⅡschizophrenia were randomly divided into Chinese medicine group and western medicine group.Patients in western medicine group were treated with aripiprazole,and those in Chinese medicine group were treated with Buyang Huanwu decoction and aripiprazole.According to PANSS scale,serum brain-derived neurotrophic factor(BDNF),Wisconsin card sorting test(WCST)computer version,the mental symptoms and cognitive function were detected at baseline and at the end of the 6th week.Results 33 cases in Chinese medicine group and 34 cases in Western medicine group were detected.The total effective rate of Chinese medicine group was 39.39%,and that of Western medicine group was 17.65%,the difference was statistically significant(P﹤0.05).Significant difference were detected in the total score of PANSS of Western medicine group and Chinese medicine group before and after treatment(P﹤0.01).At the end of the 6th week,there was significant difference in the total score of PANSS between the two groups(P﹤0.05).The serum BDNF of Chinese medicine group was significantly different before and after treatment(P﹤0.05).Taking the WCST highest normal value as the baseline,there were significant differences in total number of errors(TE)and perseverative responses(PR)and nonperseverative errors(NPE)with the baseline on the two groups(P﹤0.05).While at the 6th weekend the WCST results showed that PR in Western medicine group and TE or PR in Chinese medicine group both improved,showing no statistical significance compared with the baseline.Conclusions Buyang Huanwu decoction can further improve the mental symptoms of the patients of typeⅡschizophrenia,elevated serum BNDF concentration,reduce the cognitive defects,and finally increase the treatment effect.It can be used for adjuvant treatment of schizophrenia.