防己地黄汤联合喹硫平对双相情感障碍躁狂发作病人认知功能及炎性因子的影响

Effect of Fangji Dihuang Decoction Combined with Quetiapine on Cognitive Function and Inflammatory Factors in Bipolar Disorder Manic Episode Patients

目的观察防己地黄汤联合喹硫平治疗双相情感障碍躁狂发作的临床疗效及对病人认知功能、炎性因子的影响。方法选取2018年1月—2019年12月在山东中医药大学附属医院脑病科门诊及病房治疗的双相情感障碍躁狂发作病人60例,采用随机数字表法分为治疗组和对照组,每组30例。治疗组给予防己地黄汤联合喹硫平治疗,对照组给予喹硫平治疗,连续治疗8周后评定疗效。比较两组Bech-Rafaelsen躁狂量表(BRMS)评分、阳性和阴性症状量表(PANSS)评分、威斯康星卡片分类测验(WCTS)、连线测验(TMT)、言语记忆测验(HVLT-R)、持续操作测验(CPT)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-4(IL-4)水平。结果治疗组总有效率为93.3%,高于对照组的66.7%,差异有统计学意义(P<0.05)。治疗组治疗后BRMS评分、PANSS评分、WCTS测验、TMT测验、HVLT-R评分、CPT评分均较治疗前明显改善(P<0.05),且均较对照组明显改善(P<0.05)。治疗组治疗后血清TNF-α、IL-1β、IL-4水平均较治疗前及对照组治疗后降低(P<0.05)。治疗组不良反应发生率为3.3%,低于对照组的20.0%,两组比较差异有统计学意义(P<0.05)。结论防己地黄汤联合喹硫平治疗双相情感障碍躁狂发作病,可有效改善病人认知功能,降低病人血清炎性因子,提高临床疗效。

Objective To observe the clinical effect of Fangji Dihuang decoction combined with quetiapine in the treatment of bipolar affective disorder manic episode and its influence on cognitive function and inflammatory factors.Methods Sixty patients with bipolar disorder manic episode were randomly divided into treatment group and control group according to the random number table generated by computer.Among them,30 patients in treatment group were treated with Fangji Dihuang decoction combined with quetiapine,30 patients in control group were treated with quetiapine,and the therapeutic effect was evaluated after 8 weeks of continuous treatment.Bech-Rafaelsen Manic Scale(BRMS)scores,Positive and Negative Symptom Scale(PANSS)scores,the levels of Wisconsin Card Sorting Test(WCTS),Trail Making Test(TMT),the Hopkins verbal learning test(HVLT-R),continuous operation test(CPT),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-4(IL-4)were compared between two groups.Results The total effective rate in treatment group was higher than that in control group(93.3%and 66.7%,P<0.05).The BRMS score,PANSS score,WCTS test score,TMT test score,HVLT-R score,and CPT score in treatment group were significantly better than those in control group(P<0.05).The levels of TNF-α,IL-1β,and IL-4 in treatment group decreased significantly(P<0.05).The incidence of adverse reactions in treatment group(3.3%)was lower than that in control group(20.0%),the difference was statistically significant(P<0.05).Conclusion Fangji Dihuang decoction combined with quetiapine can effectively improve the cognitive function,reduce the serum inflammatory factors,and improve clinical efficacy in bipolar disorder manic episode patients.