补肾健脾汤联合鲁拉西酮片治疗脾肾两虚证精神分裂症患者的临床效果观察

Observation on clinical effects of Bushen Jianpi decoction combined with lurasislone tablets in the treatment of schizophrenic patients with spleen-kidney deficiency syndrome

目的 研究补肾健脾汤联合鲁拉西酮片治疗脾肾两虚证精神分裂症患者的临床效果。方法 选92例脾肾两虚证精神分裂症患者为研究对象,行随机数字表法分为试验组和对照组,每组47例。对照组行鲁拉西酮片口服治疗,试验组在对照组基础上行补肾健脾汤治疗。比较两组患者治疗效果,治疗前后阳性与阴性症状量表(PANSS)评分、自知力与治疗态度问卷(ITAQ)评分、脑内神经递质[γ-氨基丁酸(GABA)、谷氨酸(GLU)、多巴胺(DA)]水平,不良反应发生率。结果 试验组的治疗总有效率97.87%高于对照组的80.85%,差异有统计学意义(P<0.05)。试验组治疗期间无不良反应发生,对照组治疗期间发生头痛2例(4.26%)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,试验组的阳性症状、阴性症状、精神病理症状评分及总分分别为(12.61±3.27)、(13.25±2.67)、(25.23±4.65)、(51.09±10.57)分,低于对照组的(15.09±3.86)、(16.03±3.28)、(29.86±5.27)、(60.98±11.72)分, ITAQ评分(15.88±2.51)分高于对照组的(14.09±2.34)分,差异有统计学意义(P<0.05)。治疗后,试验组的GABA(7.24±1.13)、GLU(6.61±1.34)高于对照组的(6.71±1.25)、(5.72±1.28), DA(4.31±1.06)低于对照组的(5.38±1.21),差异有统计学意义(P<0.05)。结论 补肾健脾汤联合鲁拉西酮片治疗脾肾两虚证精神分裂症患者可显著提高其治疗效果,对减轻患者疾病临床症状、改善自知力与治疗态度等具有积极作用,还能纠正患者脑内神经递质紊乱问题,安全性高,值得推广。

Objective To study the clinical effect of modified Bushen Jianpi decoction combined with lurasislone tablets in the treatment of schizophrenic patients with spleen-kidney deficiency syndrome.Methods 92 schizophrenic patients with spleen-kidney deficiency syndrome were studied and divided into experimental group and control group by random number table method,with 47 cases in each group.The control group was treated with lurasidone orally,while the experimental group was treated with Bushen Jianpi decoction on the basis of the control group.Patients in both groups were compared in terms of treatment effects,positive and negative symptom scale(PANSS)score,insight and treatment attitudes questionnaires(ITAQ)score,levels of brain neurotransmitters[gamma-aminobutyric acid(GABA),glutamic acid(GLU),dopamine(DA)]before and after treatment,and incidence of adverse reactions.Results The total effective rate of the experimental group was 97.87%,which was higher than 80.85%in the control group,and the difference was statistically significant(P<0.05).There were no adverse reactions during treatment in the experimental group,while in the control group,2 cases(4.26%)experienced headaches during the treatment.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the scores of positive symptom,negative symptom,psychopathological symptom and total score of the experimental group were(12.61±3.27),(13.25±2.67),(25.23±4.65)and(51.09±10.57)points,which were lower than(15.09±3.86),(16.03±3.28),(29.86±5.27)and(60.98±11.72)points in the control group;ITAQ score of(15.88±2.51)points in the experimental group was higher than(14.09±2.34)points in the control group;the difference was statistically significant(P<0.05).After treatment,GABA of(7.24±1.13)and GLU of(6.61±1.34)in the experimental group were higher than(6.71±1.25)and(5.72±1.28)in the control group;DA of(4.31±1.06)in the experimental group was lower than(5.38±1.21)in the control group;the difference was statistically significant(P<0.05).Conclusion The treatment of schizophrenic patients with spleen-kidney deficiency syndrome by combining Bushen Jianpi decoction with lurasidone tablets can significantly improve their therapeutic effect,and has a positive effect on reducing clinical symptoms of the disease,improving self-awareness and treatment attitude,and also correcting the problem of neurotransmitter disorder in the brain of patients with high safety,which is worth promoting.