针药并用对精神分裂症患者认知功能及血清Hcy、NRG-1影响

Impact of Acupuncture Combined with Medication on Cognitive Function and Serum Hcy and NRG-1 in Patients with Schizophrenia

目的观察针刺联合奥氮平对精神分裂症患者认知功能及血清同型半胱胺酸(Hcy)、神经调节蛋白1(NRG-1)的影响。方法将66例精神分裂症患者随机分为对照组和观察组,每组33例。对照组予口服奥氮平,观察组在对照组治疗基础上予针刺督脉穴。观察两组治疗前后阳性与阴性症状量表(PANSS)评分、精神分裂症认知功能成套测验(MCCB)评分及血清Hcy、NRG-1水平变化,并比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组PANSS评分均降低(P<0.05),观察组低于对照组(P<0.05)。治疗后,对照组MCCB中注意/警觉、工作记忆、言语学习、社会认知的分值明显升高(P<0.05),信息处理速度、视觉学习、推理和问题解决的分值无明显改变(P>0.05);观察组信息处理速度、注意/警觉、工作记忆、言语学习、视觉学习、推理和问题解决、社会认知的分值均升高(P<0.05),且信息处理速度、注意/警觉、言语学习、视觉学习、推理和问题解决、社会认知的分值高于对照组(P<0.05)。治疗后,两组血清Hcy、NRG-1水平均改善(P<0.05),观察组优于对照组(P<0.05)。结论针药并用治疗精神分裂症疗效显著,能同时改善患者精神症状及认知功能,可能与其调节血清Hcy、NRG-1水平有关。

Objective To observe the impact of acupuncture plus Olanzapine on cognitive function and serum homocysteine(Hcy)and neuregulin 1(NRG-1)in schizophrenic patients.Method Sixty-six schizophrenic patients were randomized into a control group and an observation group,with 33 cases in each group.The control group received oral Olanzapine,and the observation group received additional acupuncture at Governor Vessel points.Before and after the intervention,the positive and negative symptom scale(PANSS)score,MATRICS consensus cognitive battery(MCCB)score,and serum Hcy and NRG-1 levels were observed.The clinical efficacy was also compared between the two groups.Result The total effective rate in the observation group was higher than in the control group(P<0.05).After the treatment,the PANSS score dropped in both groups(P<0.05)and was lower in the observation group than in the control group(P<0.05).After the treatment,the scores of attention/alert,working memory,language learning,and social cognition in MCCB notably increas ed in the control group(P<0.05),while the scores of information processing speed,visual study,and reasoning and problem solving showed no significant changes(P>0.05).In the observation group,the scores of information processing speed,attention/alert,working memory,language learning,visual study,reasoning and problem solving,and social cognition increased markedly(P<0.05),and the scores of information processing speed,attention/alert,language learning,visual study,reasoning and problem solving,and social cognition were higher than those in the control group(P<0.05).After the treatment,the serum Hcy and NRG-1 levels improved in both groups(P<0.05)and were better in the observation group than in the control group(P<0.05).Conclusion Acupuncture combined with medication can produce significant efficacy in treating schizophrenia.It can simultaneously improve the mental state and cognitive function,which may be associated with regulating the serum Hcy and NRG-1 levels.