附子理中丸治疗精神分裂症服用氯氮平后流涎临床研究

Clinical Study on Fuzi Lizhong Pills for Salivation After Taking Clozapine in Schizophrenia

目的:观察附子理中丸治疗精神分裂症服用氯氮平后流涎的临床疗效。方法:选择45例精神分裂症单独服用氯氮平后出现流涎的患者为研究对象,根据入组顺序随机分为2组。对照组22例采用溴丙胺太林片治疗,治疗组23例采用附子理中丸联合溴丙胺太林片治疗。比较2组临床疗效及不良反应,并比较2组治疗前、治疗1周末、治疗2周末中医证候积分、流涎严重程度评分、血清胆碱酯酶水平。结果:治疗组临床总有效率86.96%,高于对照组59.09%(P<0.05)。与同组治疗前比较,2组治疗1周末、治疗2周末气短乏力、神疲嗜卧、食欲不振、自汗气喘、流涎等中医证候积分及锥体外系副反应量表(RSESE)流涎项评分、流涎严重程度评分均降低(P<0.05),血清胆碱酯酶水平均升高(P<0.05);与对照组治疗1周末、治疗2周末比较,治疗组同期气短乏力,神疲嗜卧、食欲不振、自汗气喘、流涎等中医证候积分及RSESE流涎项评分、流涎严重程度评分均较低(P<0.05),血清胆碱酯酶水平均较高(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:附子理中丸联合溴丙胺太林片可改善精神分裂症服用氯氮平后所致流涎患者的临床症状,提高血清胆碱酯酶水平及临床疗效。

Objective:To observe the clinical effect of Fuzi Lizhong pills for salivation after taking clozapine in schizophrenia.Methods:A total of 45 cases of schizophrenia patients with salivation after taking clozapine only were selected as the study subjects and randomly divided into two groups according to enrollment order.The control group(22 cases)was treated with propantheline bromide tablets,and the treatment group(23 cases)were treated with Fuzi Lizhong pills combined with propantheline bromide tablets.Clinical effects and adverse reactions were compared between the two groups.Chinese medicine syndrome scores,scores of severe degree of salivation and levels of serum cholinesterase were compared between the two groups before treatment,after one-week treatment and after two-week treatment.Results:The total clinical effective rate was 86.96%in the treatment group,higher than that of 59.09%in the control group(P<0.05).When compared with those before treatment,Chinese medicine syndrome scores of short breath and lack of strength,lassitude of spirit and somnolence,poor appetite,spontaneous sweating and dyspnea,and salivation as well as scores of salivation in Rating Scale For Extrapyramdal Side Effects(RSESE)and the severe degree of salivation in the two groups were decreased after one-week and two-week treatment(P<0.05),and levels of serum cholinesterase were increased(P<0.05).When compared with those in the control group after one-week and two-week treatment,Chinese medicine syndrome scores of short breath and lack of strength,lassitude of spirit and somnolence,poor appetite,spontaneous sweating and dyspnea,and salivation as well as scores of salivation in RSESE and the severe degree of salivation in the treatment group at the same period were lower(P<0.05),and level of serum cholinesterase was higher(P<0.05).There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:Fuzi Lizhong pills combined with propantheline bromide tablets can improve clinical symptoms of schizophrenia patients with salivation after taking clozapine,and enhance level of serum cholinesterase and clinical effect.