中药方剂辅助氯氮平治疗慢性精神分裂症的效果观察

Observation on the Effect of Traditional Chinese Medicine Prescription Assisted with Clozapine in the Treatment of Chronic Schizophrenia

目的:分析中药方剂联合氯氮平治疗慢性精神分裂症患者的临床治疗效果及安全性。方法:纳入2021年3月—2022年12月本院接诊的慢性精神分裂症患者184例,随机分为对照组92例和研究组92例。研究组根据中医辨证分型选择中药方剂联合氯氮平共同治疗,对照组仅以氯氮平治疗。比较两组PANSS、MCCB、TESS量表评分,治疗有效率及神经递质血清标记物指标。结果:研究组治疗4周、8周时阳性症状、阴性症状、一般精神病理评分低于对照组(P<0.05);研究组治疗8周时加工速度、注意、工作记忆、语言学习、视觉学习、推理和问题解决、社交认知评分高于对照组(P<0.05);研究组治疗8周时血DA、NE、5-HT、BDNF水平高于对照组(P<0.05);研究组治疗总有效率高于对照组(P<0.05);研究组治疗4周、8周时TESS评分均低于对照组,差异有统计学意义(P<0.05)。结论:针对慢性精神分裂病症患者,中药方剂联合氯氮平治疗可积极缓解患者临床精神症状表现,减少西药不良反应的发生,维护患者临床治疗安全。

Objective:To analyze the clinical efficacy and safety of traditional Chinese medicine combined with clozapine in the treatment of patients with chronic schizophrenia.Methods:A total of 184 patients with chronic schizophrenia admitted to our hospital from March 2021 to December 2022 were randomly divided into control group(n=92)and study group(n=92).The study group was treated with traditional Chinese medicine combined with clozapine according to TCM syndrome differentiation,while the control group was treated with clozapine only.The PANSS,MCCB,TESS scale scores,treatment efficiency and neurotransmitter serum markers were compared between the two groups.Results:The scores of positive symptoms,negative symptoms and general psychopathology in the study group were lower than those in the control group at 4 and 8 weeks of treatment(P<0.05).The scores of processing speed,attention,working memory,language learning,visual learning,reasoning and problem solving,and social cognition in the study group were higher than those in the control group at 8 weeks of treatment(P<0.05).The levels of DA,NE,5-HT and BDNF in the study group were higher than those in the control group at 8 weeks of treatment(P<0.05).The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).The TESS scores of the study group were lower than those of the control group at 4 and 8 weeks of treatment(P<0.05).Conclusion:For patients with chronic schizophrenia,traditional Chinese medicine prescription combined with clozapine can actively alleviate the clinical mental symptoms of patients,reduce the occurrence of side effects of western medicine,and maintain the safety of clinical treatment of patients.