清神醒脑汤配合无抽搐电休克治疗双相情感障碍躁狂发作临床研究

Clinical Study on Qingshen Xingnao Decoction Combined with Modified Electroconvul⁃sive Therapy for Manic Episode of Bipolar Disorder

目的:观察清神醒脑汤配合无抽搐电休克治疗痰火扰神证双相情感障碍躁狂发作的临床疗效。方法:选取112例痰火扰神证双相情感障碍躁狂发作患者为研究对象,按随机数字表法分为研究组与对照组各56例。对照组给予无抽搐电休克治疗,研究组在对照组基础上给予清神醒脑汤治疗。治疗2个月后评价临床疗效,以及治疗前后中医证候评分、Bech-Rafaelsen躁狂量表(BRMS)评分、智力状态量表(MMSE)评分及匹茨堡睡眠质量指数量表(PSQI)评分。结果:治疗后,研究组总有效率为92.86%,对照组为78.57%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组头痛躁狂、彻夜不眠、面红耳赤、两目怒视、骂人毁物、高歌狂呼、狂乱莫制等中医证候评分均较治疗前降低(P<0.05),且研究组上述各项中医证候评分均低于对照组(P<0.05)。治疗后,2组BRMS评分较治疗前降低(P<0.05),MMSE评分较治疗前上升(P<0.05);且研究组BRMS评分低于对照组(P<0.05),MMSE评分高于对照组(P<0.05)。治疗后,2组PSQI评分较治疗前降低(P<0.05),且研究组PSQI评分低于对照组(P<0.05)。结论:清神醒脑汤配合无抽搐电休克治疗有利于减轻痰火扰神双相情感障碍躁狂发作的临床症状,改善患者躁狂程度,提高其认知功能及睡眠质量,临床疗效显著。

Objective:To observe the therapeutic effect of Qingshen Xingnao Decoction combined with modified electroconvulsive therapy(MECT)on manic episode of bipolar disorder.Methods:A total of 112 patients with manic episode of bipolar disorder were selected as the research objects,and were divided into the study group and the control group according to random number table method,with 56 cases in each group.The control group was given non-convulsive electroconvulsive therapy,and the study group was additionally given Qingshen Xingnao Decoction based on the treatment of the control group.Two months after treatment,the clinical effects were evaluated,and the traditional Chinese medicine(TCM)syndrome scores,Bech-Rafaelsen Mania Scale(BRMS),Mini-Mental State Examination(MMSE)and Pittsburgh Sleep Quality Index(PSQI)were compared before and after treatment between the two groups.Results:After treatment,the total effective rate was 92.86%in the study group and 78.57%in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores of headache and mania,sleepless night,flushed face,angry eyes,cursing and destroying objects,singing and screaming,and frenziness and being unable to control in the two groups were all decreased when compared with those before treatment(P<0.05),and the above TCM syndrome scores in the study group were lower than those in the control group(P<0.05).After treatment,the BRMS scores were decreased when compared with those before treatment(P<0.05),and the MMSE scores were increased when compared with those before treatment(P<0.05);the BRMS score in the study group was lower than that in the control group(P<0.05),and the MMSE score was higher than that in the control group(P<0.05).After treatment,the PSQI scores in both groups were decreased when compared with those before treatment(P<0.05),and the PSQI score in the study group was lower than that in the control group(P<0.05).Conclusion:Qingshen Xingnao Decoction combined with MECT helps to reduce the clinical symptoms of patients with manic episode of bipolar disorder,lessen the degree of mania,and improve the cognitive function and sleep quality,with significant clinical effect.