精神分裂症精神衰退的中医药治疗

精神分裂症,是精神病中较多见的一种。目前,精神病院中收治的精神分裂症病人,属于复发者越来越多,随着病程延长、反复发作、入院次数增加,这些病人中。

精神分裂症患者血浆高香草酸浓度与临床症状、性别和药物治疗的关系

目的 通过分析精神分裂症患者中枢多巴胺代谢产物 血浆高香草酸浓度 (pHVA)与临床指征的关系 ,进一步探讨多巴胺神经递质及其药物治疗在精神分裂症的作用。方法 在 46例长期药物治疗、5 8例未治疗精神分裂症患者中 ,采用高液相色谱连接电化学分析仪测定pHVA ;测前评定阳性症状量表 (SAPS)和阴性症状量表 (SANS)。结果 (1)与 6 2例健康对照组比 ,治疗组pH VA显著减低 ;未治疗组显著增高 ,以阴性症状组为著。 (2 )未治疗组患者pHVA与SAPS或SANS总分无显著相关 ,但与SANS因子分—兴致、社交缺乏显著正相关 (r=0 32 ,P <0 0 5 ) ;男性患者pH VA与SANS总分显著正相关 (r =0 42 ,P <0 0 5 ) ,而与SAPS因子分 阳性思维形式障碍 (r =-0 5 4,P <0 0 1)和妄想 (r=- 0 5 0 ,P <0 0 1)显著负相关。治疗组pHVA与SANS因子分 思维贫乏(r=0 38,P <0 0 5 )呈正相关。结论 一些主要伴有阴性症状的精神分裂症患者 (男性 )中枢多巴胺转化增强 ,提示多巴胺能神经元活性的改变可能与该病神经发育异常导致的神经病理改变有关 ,且存在性别差异 ;抗精神病药物治疗能减低中枢多巴胺转化 ,从而改善精神症状。

清心汤为主治疗精神分裂症80例疗效观察

我们以清心汤为主,配合中、小剂量的抗精神病药物治疗精神分裂症80例(治疗组),与单纯西药治疗的80例(对照组)进行对比观察,结果表明治疗组疗效好,副作用少,明显优于对照组(P<0.05)。

阿立哌唑与氯氮平对精神分裂症患者心电图的影响

目的探讨阿立哌唑与氯氮平对精神分裂症患者心电图的影响。方法将95例精神分裂症患者随机分为研究组（48例）和对照组（47例），分别应用阿立哌唑与氯氮平治疗。观察8周。于治疗前及治疗后第4周、8周末进行心电图检查。结果阿立哌唑组实性心动过速、T波改变、ST段改变、QT间期延长发生率均显著低于氯氮平组（P〈0．05或0．01）；治疗第4周、8瑚末，阿立哌唑组心电图异常发生率分别为12．50％、20．83％，氯氮平组分别为53.19％、68．09％，同期两组间比较差异均有极显著性（P〈0．01）。结论阿立哌唑和氯氮平对精神分裂症患者的心电图均有影响，但阿立哌唑致心电图改变发生率低于氯氮平，程度较轻，安全性相对较高。

健康教育对精神分裂症患者康复的影响

目的:研究健康教育对精神分裂症患者康复的影响。方法:将100例精神分裂症患者以随机入组的方法入组,每组各50例。研究组在常规药物治疗的同时给予系统的健康教育;对照组仅接受常规药物治疗及一般指导。两组分别在出院后随访一年,以复发率、治疗依从性、参加劳动率、生活自理、SDSS等为康复指标。结果:接受健康教育组各项康复指标均优于未接受健康教育组。结论:健康教育对精神分裂症患者康复效果显著。

Association of RELN promoter SNPs with schizophrenia in the Chinese population

Previous research on gene expression analysis and association tests have suggested that RELN is a risk gene for schizophrenia in world populations.Based on the reported down-regulation of RELN in schizophrenia patients compared with normal subjects,we speculated that variants in the RELN promoter region may confer risk for schizophrenia.In this study,we investigated the associations of three SNPs in the promoter region of RELN with schizophrenia in a case-control sample from southwestern China（940 cases and 13 69 controls）.The results suggested that none of the SNPs showed significant associations in our sample,indicating the risk variants for schizophrenia in RELN may not be located in the promoter region.We also performed meta-analysis by combining our data with previously reported data on the Chinese population with a total sample size of 2 843 individuals,and the result remained nonsignificant.Collectively,our results suggested variants in the RELN promoter may not harbor risk SNPs associated with schizophrenia in the Chinese population.

No changes in densities of cannabinoid receptors in the superior temporal gyrus in schizophrenia

Objective In recent years,abnormal changes in the endocannabinoid system have been found in schizophrenia. The superior temporal gyrus（STG）is strongly implicated in the pathophysiology of schizophrenia,particularly with regards to auditory hallucinations.In this study,we investigated the binding density of cannabinoid CB1 receptors in the STG of schizophrenia patients compared to control subjects.Methods Quantitative autoradiography was used to investigate the binding densities of[^3H]SR141716A（a selective antagonist）and[^3H]CP-55940（an agonist）to the CB1 receptors in the STG.Post-mortem brain tissue was obtained from the NSW Tissue Resource Centre（Australia）.Results Contrasting to previous findings in the alterations of CB1 receptor densities in the prefrontal,anterior and posterior cingulate cortex of schizophrenia,which were suggested to be associated to impairment of cognition function,no significant difference was found between the schizophrenia and control cases in both[^3H]SR141716A and[^3H]CP-55940 binding. Conclusion We suggest that CB1 receptors in the STG are not involved in the pathology of schizophrenia and the auditory hallucination symptom of this disease.

Imbalanced free radicals and antioxidant defense systems in schizophrenia:A comparative study

Objective: To examine changes of blood oxidative-antiovidative level in schizophrenic patients and its relationship with clinical symptoms. Methods: Forty-six Chinese patients met DSM-IV (Diagnostic and Statistical Manual of Mental Disor- ders-IV) criteria for schizophrenia and fifty age- and sex-matched healthy controls were enrolled in the present study. Baseline psychiatric symptom severity was assessed with brief psychiatric rating scale, positive and negative syndrome scale on the blood draw day. Fresh blood samples were collected to measure levels of nitric oxide and lipid peroxide in plasma as well as activities of superoxide dismutase, catalase and glutathione peroxidase in red blood cells by spectrophotometric assays simultaneously. Results: Comparison of the biochemical parameters indicated that the level of nitric oxide and lipid peroxide increased in patient group, which represented a positive correlation with positive scale scores; while the activities of three critical enzymes decreased and showed a negative linear correlation. Conclusion: This study showed that there are dysregulation of free radical metabolism and poor activities of the antioxidant defense systems in schizophrenic patients. Excess free radicals formation may play a critical role in the etiology of schizophrenia. Using antioxidants might be an effective therapeutic approach to partially alleviate or prevent the symptoms of schizophrenia.

Neurotoxicity and Biomarkers of Lead Exposure: a Review

Appropriate selection and measurement of lead biomarkers of exposure are critically important for health care management purposes,public health decision making,and primary prevention synthesis.Lead is one of the neurotoxicants that seems to be involved in the etiology of psychologies.Biomarkers are generally classified into three groups:biomarkers of exposure,effect,and susceptibility.The main body compartments that store lead are the blood,soft tissues,and bone;the half-life of lead in these tissues is measured in weeks for blood,months for soft tissues,and years for bone.Within the brain,lead-induced damage in the prefrontal cerebral cortex,hippocampus,and cerebellum can lead to a variety of neurological disorders,such as brain damage,mental retardation,behavioral problems,nerve damage,and possibly Alzheimer’s disease,Parkinson’s disease,and schizophrenia.This paper presents an overview of biomarkers of lead exposure and discusses the neurotoxic effects of lead with regard to children and adults.

Effect of ziprasidone on QTc interval in Chinese patients with schizophrenia

Objective： To investigate the effect of ziprasidone on QTc in Chinese patients with schizophrenia. Methods： The study involved 27 patients with schizophrenia. Ziprasidone was initiated with 40 mg/day. From day 3 to day 7, the dose was increased gradually to 120-160 mg/d according to the effectiveness and tolerahility. QTc values were measured at the beginning and month 6. Results： At the beginning of the 6 months treatment, the mean QTc interval of patients was （387.5±19.0） ms. At the end of the study, it was （402.9±23.6） ms. The difference has statistically significance （P〈0.05）. The mean QTc interval changed significantly throughout 6-months period but no one exceed the QTc dangerous limits. Significant correlation was found between QTc interval and the dose. Conclusion： In summary, our results suggest that ziprasidone has good tolerance in patient with schizophrenia despite its dose-related QTc prolongation. Ziprasidone have no pro-arrhythmic profile

Allosteric modulation of cholinergic system:Potential approach to treating cognitive deficits of schizophrenia

Schizophrenia is a psychiatric disorder affecting approximately 1% of the population worldwide and is characterised by the presence of positive and negative symptoms and cognitive deficits. Whilst current therapeutics ameliorate positive symptoms, they are largely ineffective in improving negative symptoms and cognitive deficits. The cholinergic neurotransmitter system heavily influences cognitive function and there is evidence that implicates disruption of the central cholinergic system in schizophrenia. Historically, targeting the cholinergic system has been impeded by poor selectivity leading to intolerable side effects warranting the need to develop more targeted therapeutic compounds. In this review we will summarise evidence supporting the roles of the cholinergic system, particularly the muscarinic M1 receptor, in the pathophysiology of schizophrenia and discuss the potential of a promising new class of candidate compounds, allosteric ligands, for addressing the difficulties involved in targeting this system. The body of evidence presented here highlights the dysfunction of the cholinergic system in schizophrenia and that targeting this system by taking advantage of allosteric ligands is having clinically meaningful effect on cognitive deficits.

DTNBP1 Gene Is Associated with Some Symptom Factors of Schizophrenia in Chinese Han Nationality

Objective To study the association of DTNBP1 gene with some symptom factors of schizophrenia.Methods A total of 285 unrelated schizophrenic individuals were recruited from December 2004 to January 2009 for genetic analysis,and their symptom factors were assessed based on the Positive and Negative Syndrome Scale(PANSS).The quantitative trait test was performed by the UNPHASED program(version 3.0.12) to investigate the association between scored positive and negative symptoms and the single nucleotide polymorphisms(SNPs) in DTNBP1 gene.Results The quantitative trait test showed allelic association of rs909706 with the excitement symptom of schizophrenia(P<0.05,adjusted by 10 000 permutations),while the genotype C/G of rs2619539 with a negative symptom,lack of spontaneity and flow of conversation(P<0.05,adjusted by 10 000 permutations).Conclusion DTNBP1 variations are possibly associated with some symptoms of schizophrenia,which could partly explain the relationship between the susceptibility gene DTNBP1 and that disease.

Personal Experience in Acupuncture Treatment of Mental Diseases

Under the guidance of family veteran Chinese physicians, the author has been pursuing the research and treatment of mental diseases with Chinese herbal medicine supplemented by acupuncture and moxibustion with satisfactory therapeutic effects which is introduced as follows.

FOLLOW-UP STUDY ON AUDITORY EVOKED POTENTIAL P50 IN FIRST-EPISODE SCHIZOPHRENIA

Objective To investigate the variation of auditory evoked potential P50 in first-episode schizo- phrenia. Methods P50 was recorded from 66 schizophrenics and 92 normal controls with American Brova instrument, and assessing their psychotic symptoms with PANSS. Results Compared with NC, schizophrenics showed sensory gating deficit, reflecting by increased S2/S1 ratio (NC: 42±21% , Sch:81±40% ,P <0. 01). No significant correlation was found between PANSS score and the three markers for assessing the sensory gating, such as the S2/S1 ratio, S2-S1, and 100 (1 -S2/S1) (P > 0. 05). Schizophrenics showed no differences with P50 markers between the 5 weeks and 12 weeks of treatment. Conclusion P50 might be biological trait marker of schizophrenia.

Schizophrenia and Other Psychoses in Polish Middletown

The most of studies conducted up till now have shown a frequent occurrence of schizophrenia and other psychoses in cities compared to rural and suburban areas. The following research work was done on the basis of address data in a medium size town of people placed in psychiatric hospitals schizophrenia and other psychoses in the years 1989-2002. ICD9 criteria were initially used for hospital diagnosis, and then ICD10 criteria. To study the differences among particular districts of the town the test for two proportions was conducted. The analyzed group of persons amounted to 380 patients, including 169 men and 211 women. It indicated that patients more frequently lived in more urbanized and postindustrial districts of town as well as men aged 20-29 years old in postindustrial districts. It should be mentioned that more of patients placed the inner city, but also in postindustrial district and in districts with city housinz oroiects.

Paul Tillich＇s Schizophrenia

Paul Tillich once confided to his secretary at Harvard that he was a schizophrenic. In this article, the author, who is also a schizophrenic, discusses symptoms of schizophrenia in Tillich＇s biography and theology. Tillich had always insisted that his theology was one of the kairos. By hiding his theological thought behind an arcane Greek word, Tillich dissimulated his own messiah complex. On several occasions, Tillich describes a mystical schizophrenic hallucination with such accuracy that it is obvious to those who have had similar visions that he was speaking from personal experience. This article raises unanswerable questions about the relationships between religious revelation, mystical ecstasy and schizophrenia.

A Motherland That One Cannot Return to An Interpretation on Song of The Chu From a Perspective of Cultural Security

Song of The Chu, a novel written by LAN Zi-- a Chinese Australian writer, recounts the struggle in Australia over 20 years （1988-2008） of a group of Chinese young people. Cultural difference or even conflict is one of the inevitable issues in terms of migration. The Chinese （Han） culture which belongs to the continental civilization and the Australian （Western） culture which belongs to the maritime one are both mighty and cannot be conquered or assimilated by each other. This means that the Chinese immigrants to Australia, compared to the ones from a less mighty culture, are more sensitive and resistant to the impact of an alien culture, which leads to a conscious or unconscious sense of security of the mother culture. Cultural security, not unidirectional, also refers to the worry by the locals of the impact brought by the immigrants. The protagonist resorts to converting to Buddhism as a solution to the cultural schizophrenia

ILLUSTRATIVE CASES TREATED BY THE APPLICATION OF THE EXTRA POINT SISHENCONG

The president of our hospital, Dr. Chen Daoyi, has rich experience in the clinical us age of Sishencong (Extra 6). Having learnt from him, now Ⅰ present a few cases, in which the patients have been treated with this extra point.

A double-blind,placebo-controlled study of traditional Chinese medicine sarsasapogenin added to risperidone in patients with negative symptoms dominated schizophrenia

Objective To identify whether sarsasapogenin, a sapogenin from the Chinese medicinal herb Anemarrhena Asphodeloides Bunge, would augment the efficacy of risperidone and significantly improve cognitive functions in patients with negative symptoms dominated schizophrenia. Methods The trial was a double-blind, placebo-controlled, parallel- group design. The eligible patients were randomized into 2 treatment groups： sarsasapogenin group （sarsasapogenin plus risperidone for 8 weeks, n = 41） and placebo group （risperidone only for 8 weeks, n = 39）. At the baseline, as well as at weeks 2, 4 and 8 of treatment, the therapeutic response was measured by using scales including Positive and Nega- tive Symptoms Scale （PANSS）, Wechsler Memory Scale （WMS）, modified Chinese Wechsler Adult Intelligence Scale （mWAIS）, Clinical Global Impression （CGI） and Brief Psychiatry Rating Scale （BPRS）. The study period for each subject was 8 weeks and duration of overall trial was 2 years. Results Patients treated with sarsasapogenin plus risperidone demonstrated no statistically significant differences in changes in PANSS, WMS or mWAIS score at the end-point of the trial compared with patients treated with placebo plus risperidone. The incidence of treatment-emergent adverse events in patients treated with sarsasapogenin was not different from that observed in placebo group. Conclusion Sarsasapogenin did not augment the efficacy of risperidone in treating negative symptoms dominated schizophrenia. Sarsasapogenin at a dosage of 200 mg per day added to a flexible dosage of risperidone at 2-4 mg per day is safe and well tolerated by patients with negative symptoms dominated schizophrenia.