益生菌对精神分裂症患者认知功能的影响

Effect of probiotics on the cognitive function of patients with schizophrenia

目的探讨益生菌对精神分裂症患者认知功能影响。方法选取2019年1月至2021年1月上海市金山区精神卫生中心收治的100例精神分裂症患者,采用随机分组表将患者分为常规组(非典型抗精神病药物联合安慰剂治疗,50例)和干预组(非典型抗精神病药物联合益生菌治疗,50例)。分别于治疗前、治疗3个月,取患者粪便进行DNA检测,比较肠道菌群组成情况,采用重复性成套神经心理状态测验量表(RBANS)评定患者认知功能,采用阳性与阴性症状量表(PANSS)评定患者精神状态,比较两组患者相关药物不良反应发生率。结果治疗前,两组梭杆菌门、变形菌门、放线菌门相对丰度比较差异无统计学意义(均P>0.05);治疗3个月,两组梭杆菌门、变形菌门、放线菌门相对丰度均较治疗前下降,且干预组下降程度更显著(均P<0.05)。治疗前,两组即刻记忆、视觉广度、言语功能、注意功能、延迟记忆及RBANS总分比较差异无统计学意义(均P>0.05);治疗3个月,两组患者即刻记忆、视觉广度、言语功能、注意功能、延迟记忆、RBANS总评分均较治疗前升高,且干预组患者升高程度更显著(均P<0.05)。治疗前,两组PANSS评分比较差异无统计学意义(P>0.05);治疗3个月,两组PANSS评分均较治疗前下降,且干预组下降程度高于常规组(P<0.05)。治疗3个月期间,两组患者相关药物不良反应发生情况比较差异无统计学意义(P>0.05)。结论益生菌在精神分裂症患者中辅助治疗,可调节患者肠道菌群,改善患者认知功能和精神障碍,且并不增加药物不良反应发生率,有显著临床疗效和较高治疗安全性。

Objective To explore the effect of probiotics on the cognitive function of patients with schizophrenia.Methods 100 schizophrenic patients admitted to Shanghai Jinshan District Mental Health Center from January 2019 to January 2021 were randomly divided into the conventional group(treated with atypical antipsychotics combined with placebo,50 cases)and the intervention group(treated with atypical antipsychotics combined with probiotics,50 cases).Before treatment and 3 months after treatment,the feces of the patients were taken for DNA detection to compare the composition of intestinal flora.The cognitive function of the patients was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),and the mental state of the patients was assessed by the Positive and Negative Symptom Scale(PANSS).The incidence of adverse drug reactions was compared between the two groups.Results Before treatment,the relative abundance of Fusobacteria,Proteus and Actinobacteria in the two groups had no statistical significant difference(all P>0.05);After 3 months of treatment,the relative abundance of Fusobacteria,Proteus and Actinobacteria in the two groups decreased compared with that before treatment,and the decline was more significant in the intervention group(all P<0.05).Before treatment,there was no significant difference in immediate memory,visual span,speech function,attention function,delayed memory and RBANS between the two groups(all P>0.05);After 3 months of treatment,the scores of immediate memory,visual span,speech function,attention function,delayed memory and RBANS in the two groups were higher than those before treatment,and the increase was more significant in the intervention group(all P<0.05).Before treatment,there was no significant difference in PANSS scores between the two groups(P>0.05);After 3 months of treatment,PANSS scores in both groups decreased compared with those before treatment,and the decrease degree in the intervention group was higher than that in the conventional group(all P<0.05).During the three months of treatment,there was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusions Probiotics are used in adjuvant therapy for patients with schizophrenia,which can regulate the patients′intestinal flora,improve patients′cognitive function and mental disorders,and do not increase the incidence of adverse drug reactions.They have significant clinical efficacy and high treatment safety.