养心汤联合针刺辨证治疗精神分裂伴幻听临床研究

Clinical Study on Yangxin Decoction Combined with Acupuncture for Treating Schizophrenia with Auditory Hallucination Based on Syndrome Differentiation

目的:在氯氮平治疗基础上,观察养心汤联合针刺辨证治疗精神分裂伴幻听患者的临床疗效及对血清炎症因子水平的影响。方法:选取82例精神分裂症伴幻听患者,按随机数字表法分为对照组和观察组各41例。对照组采用氯氮平治疗,观察组在对照组基础上加用养心汤联合针刺辨证治疗。疗程均为12周,观察2组阳性和阴性症状量表(PANSS)、听幻觉量表(AHRS)、中医情绪调查表(TCMEQ)、精神分裂症生活质量量表(SQLS)评分,以及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)]水平变化。结果:治疗后,观察组AHRS、PANSS评分均较治疗前降低(P<0.05),且观察组AHRS、PANSS评分均低于对照组(P<0.05)。治疗后,观察组TCMEQ量表主、次症评分均低于治疗前及对照组(P<0.05);对照组TCMEQ量表主、次症评分治疗前后比较,差异无统计学意义(P>0.05)。治疗后,2组SQLS量表中症状和不良反应、心理社会评分及总分均较治疗前降低(P<0.05),且观察组上述各项评分均低于对照组(P<0.05);2组SQLS量表中动力和精力评分治疗前后比较,差异无统计学意义(P>0.05)。治疗后,2组血清TNF-α、IL-1β水平均较治疗前降低(P<0.05);IL-2水平均较治疗前升高(P<0.05);且观察组TNF-α与IL-1β水平均低于对照组(P<0.05),IL-2水平高于对照组(P<0.05)。观察组不良反应发生率为4.88%,对照组为19.51%,2组比较,差异有统计学意义(P<0.05)。结论:在氯氮平基础上联合养心汤、针刺治疗精神分裂症伴幻听患者,有助于改善症状,提高患者生活质量,有效抑制机体炎症反应,且治疗安全性良好。

Objective:On the basis of Clozapine treatment,to observe the efficacy of Yangxin Decoction combined with acupuncture based on syndrome differentiation in the treatment of schizophrenia with auditory hallucinations and its effects on serum inflammatory factor levels.Methods:A total of 82 cases of patients with schizophrenia with auditory hallucinations were selected and divided into the control group and the observation group according to the random number table method,with 41 cases in each group.The control group was treated with Clozapine,and the observation group was additionally treated with Yangxin Decoction combined with acupuncture based on syndrome differentiation on top of the control group's treatment.Both groups were treated for 12 weeks.The changes in scores of Positive and Negative Syndrome Scale(PANSS),Auditory Hallucination Rating Scale(AHRS),Traditional Chinese Medicine Emotional Questionnaire(TCMEQ),and Schizophrenia Quality of Life Scale(SQLS),as well as inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-2(IL-2)]were observed in both groups.Results:After treatment,the scores of AHRS and PANSS in the observation group were decreased when compared with those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the main and secondary symptom scores of the TCMEQ in the observation group were lower than those before treatment and those in the control group(P<0.05);there was no significant difference in the main and secondary symptom scores of the TCMEQ in the control group before and after treatment(P>0.05).After treatment,the symptom and side effects,psychosocial scores,and total scores of the SQLS in both groups were reduced when compared with those before treatment(P<0.05),and all the above scores in the observation group were lower than those in the control group(P<0.05);there was no significant difference in the motivation and energy scores of the SQLS in both groups before and after treatment(P>0.05).After treatment,the levels of TNF-αand IL-1βin serum in the two groups were declined when compared with those before treatment(P<0.05),and the IL-2 levels were elevated when compared with those before treatment(P<0.05);the levels of TNF-αand IL-1βin the observation group were lower than those in the control group(P<0.05),and the IL-2 level was higher than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was 4.88%,and that in the control group was 19.51%;the difference between the two groups was significant(P<0.05).Conclusion:For patients with schizophrenia with auditory hallucination,the additional treatment of Yangxin Decoction and acupuncture based on Clozapine can help improve symptoms,enhance quality of life,and effectively inhibit the body's inflammatory responses,with good treatment safety.