五积散与小剂量阿立哌唑治疗抗精神病药物所致痰湿型闭经的临床研究

Treatment of Antipsychotic Drug- induced Phlegm Dampness Type Amenorrhea by Wuji Powder and a Small Dose Aripiprazole: a Clinical Study

目的探讨五积散与小剂量阿立哌唑治疗抗精神病药物所致痰湿型闭经的临床疗效及安全性。方法选因服抗精神病药物引起药源性闭经和(或)泌乳的女性精神分裂症患者70例,随机分为治疗组和对照组,各35例。两组患者在服用抗精神病药物的同时,治疗组给予五积散治疗,对照组给予阿立哌唑(5 mg,1次/日)治疗。治疗前后时测定催乳素(prolactin,PRL)水平、肥胖指数[体重、腰围、体重指数(BMI)及腰臀比(WHR),并进行疗效评定。结果两组总完成率为95.71%;治疗组33例,总有效率为93.94%(31/33);对照组34例,总有效率为91.18%(31/34),两组比较差异无统计学意义(P>0.05)。与治疗前比较,两组治疗后PRL水平均下降,差异均有统计学意义(均P<0.01),治疗后两组间比较差异无统计学意义(P>0.05)。与治疗前比较,治疗组治疗后体重、BMI、腰围、WHR明显降低,并较对照组降低明显,差异有统计学意义(P<0.05)。对照组治疗前后体重、BMI、腰围、WHR比较,差异无统计学意义(P>0.05)。结论五积散与阿立哌唑均能降低痰湿型闭经的精神分裂症患者的高PRL水平,且疗效相当,但五积散在降低肥胖指数方面作用更明显。

Objective To assess the efficacy and safety of Wuji Powder( WP) and a small dose aripiprazole in treatment of antipsychotic drug- induced phlegm dampness type amenorrhea. Methods Seventy female schizophrenic patients with antipsychotic drug- induced galactorrhea- amenorrhea syndrome( GAS) were recruited and randomly assigned to the treatment group and the control group,35 in each group. All patients received antipsychotic drug therapy. Patients in the treatment group additionally took WP,while those in the control group took aripiprazole( at the daily dose of 5 mg,once daily). The therapeutic course for all was 4 weeks. Prolactin levels and obesity indices[body weight、waist aircumstance、body mass index( BMI) and waist- hit ratio( WHR) ] were determined before and after treatment. The efficacy was evaluated. Results The treatment course was completed in 95. 71% of patients. The total effective rate of the 33 patients of the treatment group was 93. 94%( 31/ 33),while it was 91. 18%( 31/ 34) in the 34 patients of the control group. There was no difference in the total effective rate between the two groups(P > 0. 05). Prolactin levels in both group after treatment were significantly lower than those of the baseline(P < 0. 01). There was no significant difference in prolactin levels between the two groups after treatment(P > 0. 05).Compared with before treatment,body weight,BMI,waist circumstance,and waist- hip ratio obviously decreased after treatment,showing significant difference when compared with the control group(P < 0. 05). There was no significant difference in body weight,BMI,waist circumstance,and waist- hip ratio in the control group between before and after treatment(P > 0.05). Conclusions Both WP and aripiprazole could lower high prolactin levels of schizophrenics with phlegm dampness type amenorrhea. They showed equivalent efficacy. But WP showed more obvious effect in reducing obesity indices.