阿立哌唑与安慰剂辅助治疗方案改善慢性精神分裂症阴性症状的临床价值

Clinical value of aripiprazole and placebo adjuvant therapy in improving negative symptoms of chronic schizophrenia

目的探讨阿立哌唑与安慰剂辅助治疗改善慢性精神分裂症阴性症状的临床价值。方法选取2021年1—12月江西省荣誉军人康复医院收治的130例慢性精神分裂症患者作为研究对象,采用随机数字表法分为对照组与研究组,每组65例。对照组服用安慰剂,研究组服用阿立哌唑片治疗,比较两组治疗前后阳性与阴性症状量表(PANSS)评分及血清神经营养因子水平,分析两组治疗后神经营养因子与PANSS评分的相关性。结果治疗后,研究组阴性症状评分低于治疗前和对照组,差异有统计学意义(P<0.05);两组组内、组间治疗前后阳性症状、一般精神病理评分及PANSS总分比较差异无统计学意义。治疗后,研究组脑源性神经营养因子(BDNF)、血清神经生长因子(NGF)和神经营养因子3(NT-3)水平均高于治疗前和对照组,差异有统计学意义(P<0.05),对照组治疗前后BDNF、NGF和NT-3水平比较差异无统计学意义。Spearman相关分析结果显示,两组血清BDNF与阴性症状评分均呈负相关(r<0,P<0.05),与阳性症状评分、一般精神病理评分及PANSS总分均无相关性;两组血清NGF、NT-3与阳性症状评分、阴性症评分、一般精神病理评分及PANSS总分均无相关性。结论阿立哌唑可显著改善慢性精神分裂症阴性症状,提高血清脑源性神经营养因子水平,阴性症状严重程度与血清BDNF水平有关,临床可依据BDNF水平评估临床疗效。

Objective To explore the clinical value of aripiprazole and placebo adjuvant therapy in improving negative symptoms of chronic schizophrenia.Methods A total of 130 patients with chronic schizophrenia admitted to the Jiangxi Honorable Military Rehabilitation Hospital from January 2021 to December 2021 were selected as the study subjects,and they were divided into the control group and the study group by random number table method,with 65 cases in each group.The control group received placebo,and the study group received aripiprazole tablets treatment,the positive and negative symptom scale(PANSS)scores and serum neurotrophic factor levels were compared before and after treatment between the two groups,and the correlation between the neurotrophic factor levels and PANSS scores was analyzed.Results After treatment,the negative symptom score in the study group was lower than that before treatment and the control group,and the differences were statistically significant(P<0.05);there were no significant differences in the positive symptoms,general psychopathological scores and PANSS total scores within group and between the two groups before and after treatment.After treatment,the levels of brain-derived neurotrophic factor(BDNF),serum nerve growth factor(NGF)and neurotrophic factor 3(NT-3)in the study group were higher than those before treatment and the control group,and the differences were statistically significant(P<0.05),there was no significant difference in the levels of BDNF,NGF and NT-3 in the control group before and after treatment.Spearman correlation analysis showed that serum BDNF was negatively correlated with negative symptom score between the two groups(r<0,P<0.05),but had no correlation with positive symptom score,general psychopathological score and PANSS total score between the two groups;serum NGF and NT-3 were not correlated with positive symptom score,negative symptom score,general psychopathological score and PANSS total score between the two groups.Conclusion Aripiprazole can significantly improve the negative symptoms of chronic schizophrenia and increase the levels of serum BDNF,NGF and NT-3,the severity of negative symptoms is related to the changes of serum BDNF levels,and the clinical efficacy can be evaluated according to the level of BDNF.