芍药当归汤辅助治疗氨磺必利所致高催乳素血症的临床疗效及对患者血清催乳激素和免疫状态的影响

Clinical efficacy of Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride and its effect on serum prolactin and immune status of patients

目的观察芍药当归汤辅助治疗氨磺必利所致高催乳素血症的临床疗效及对患者血清催乳激素(PRL)和免疫状态的影响。方法将85例氨磺必利所致高催乳素血症患者按照随机数字表法分为2组。2组在原氨磺必利治疗方案不变的情况下,对照组40例予甲磺酸溴隐亭治疗;观察组45例在对照组治疗基础上予芍药当归汤辅助治疗。2组均治疗8周后统计临床疗效,并观察2组治疗前及治疗2周、4周、8周血清PRL水平,治疗前后自然杀伤(NK)细胞活性、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+)、血清免疫球蛋白(Ig)G、IgA、IgM及补体(C)3、C4,以及药物不良反应发生情况。结果观察组总有效率91.1%,对照组总有效率75.0%,观察组疗效优于对照组(P<0.05)。治疗2周、4周、8周后2组血清PRL均较本组治疗前下降(P<0.05),且观察组血清PRL水平均低于对照组同期(P<0.05)。治疗后2组NK细胞活性较本组治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后2组CD4^+水平较本组治疗前均升高(P<0.05),且观察组高于对照组(P<0.05);治疗后2组CD3^+、CD8^+较本组治疗前升高(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗后2组IgG、IgM及C3水平较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05);治疗后2组IgA、C4组间及组内比较差异均无统计学意义(P>0.05)。2组均有头痛、便秘、静坐不能等不良反应,2组各不良反应发生率比较差异无统计学意义(P>0.05)。结论芍药当归汤辅助治疗氨磺必利所致高催乳素血症能使血清PRL快速降低,改善患者免疫功能。

Objective To observe the clinical efficacy of Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride and its effect on serum prolactin(PRL) and immune status. Methods 85 patients with hyperprolactinemia caused by amisulfapride were divided into two groups according to random number table method. In the two groups, the original amisulpride treatment regimen was unchanged. 40 patients in control group were treated by bromocriptine mesylate. 45 patients in observation group were treated by Shaoyao Danggui decoction on the basis of the control group as an adjuvant treatment. The clinical efficacy was evaluated after 8 weeks of treatment in both groups. The serum PRL levels before treatment and 2 weeks, 4 weeks, and 8 weeks after treatment were observed. The natural killer(NK) cell activity and T lymphocyte subsets(CD3^+, CD4^+, CD8^+), serum immunoglobulin(Ig)G, IgA, IgM and complement(C)3, C4, and the occurrence of adverse drug reactions before and after treatment. Results The total effective rate of the observation group was 91.1% and 75.0% in the control group. The curative effect of the observation group was better than the control group(P<0.05). After 2, 4 and 8 weeks of treatment, the serum PRL levels in the two groups were lower than those in the group before treatment(P<0.05), and the serum PRL levels in the observation group were lower than those in the control group at the same time(P<0.05). After treatment, NK cell activity in the two groups was higher than that in the group before treatment(P<0.05), and the observation group was higher than the control group(P<0.05). After treatment, the levels of CD4^+ in both groups were higher than those in the group before treatment(P<0.05), and the observation group were higher than the control group(P<0.05). After treatment, the levels of CD3^+ and CD8^+ in the two groups were higher than those in the group before treatment(P<0.05), but there was no statistically significant difference between the two groups(P>0.05). After treatment, the levels of IgG, IgM and C3 in the two groups were lower than those in the group before treatment(P<0.05), and the observation group were lower than the control group(P<0.05). After treatment, there were no statistically significant differences between the two groups of IgA, C4 or within the group(P>0.05). Both groups had adverse reactions such as headache, constipation and inability to sit still. There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Shaoyao Danggui decoction in the adjuvant treatment of hyperprolactinemia caused by amisulfapride can rapidly reduce serum PRL and improve the immune function of patients.