摘要
目的:观察安神通窍汤联合碳酸锂治疗双相情感障碍躁狂发作患者的临床疗效。方法:选择100例痰瘀阻滞证双相情感障碍躁狂发作患者作为研究对象,按照随机数字表法将以上患者分为常规治疗组和安神通窍组各50例。常规治疗组单纯采用碳酸锂治疗,安神通窍组在常规治疗组基础上联合安神通窍汤治疗。2组均治疗8周。比较2组临床疗效和不良反应,比较2组治疗前后血清炎症因子水平、生活质量以及躁狂程度变化。结果:安神通窍组总有效率96.00%,高于常规治疗组84.00%(P<0.05)。治疗前,2组血清脑源性神经营养因子(BDNF)、白细胞介素-1β (IL-1β)及肿瘤坏死因子-α (TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清BDNF水平均升高(P<0.05),IL-1β、TNF-α水平均降低(P<0.05),且安神通窍组血清BDNF水平高于常规治疗组(P<0.05),IL-1β、TNF-α水平低于常规治疗组(P<0.05)。治疗前,2组霍普金斯词语学习测验(HVLT-R)评分、持续操作测验量表(CPT)评分比较,差异无统计学意义(P>0.05);治疗后,2组HVLT-R评分、CPT评分均升高(P<0.05),且安神通窍组高于常规治疗组(P<0.05)。治疗前,2组简明健康状况量表(SF-36)评分、贝克拉范森躁狂自评量表(BRMS)评分比较,差异无统计学意义(P>0.05);治疗后,2组SF-36评分升高(P<0.05),BRMS评分下降(P<0.05),且安神通窍组SF-36评分高于常规治疗组(P<0.05),BRMS评分低于常规治疗组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:安神通窍汤联合碳酸锂治疗双相情感障碍躁狂发作,能提高临床疗效及患者的生活质量、注意力及学习能力,降低躁狂程度,其作用机制可能与调节血清神经营养因子水平和炎症反应相关。
Objective:To observe the clinical effect of Anshen Tongqiao Decoction combined with lithium carbonate for manic episode in patients with bipolar disorder.Methods:A total of 100 cases of patients with phlegm stasis block type manic episode in bipolar disorder were selected as the study objects and divided into the routine treatment group and the Anshen Tongqiao group according to the random number table method,with 50 cases in each group.The routine treatment group was simply treated with lithium carbonate,and the Anshen Tongqiao group was additionally treated with Anshen Tongqiao Decoction based on the treatment of the routine treatment group.Both two groups were treated for 8 weeks.Clinical effects and adverse reactions were compared between the two groups.Changes in levels of inflammatory factors in serum,quality of life,and mania degrees before and after treatment were compared between the two groups.Results:The total effective rate was 96.00%in the Anshen Tongqiao group,higher than that of 84.00%in the routine treatment group(P<0.05).Before treatment,there was no significant difference being found in the comparison of the levels of brain-derived neurotrophic factor(BDNF),interleukin-1β(IL-1β),and tumor necrosis factor-α(TNF-α)in serum between the two groups(P>0.05).After treatment,the levels of BDNF in serum in the two groups were increased(P<0.05),and the levels of IL-1βand TNF-αwere decreased(P<0.05);the level of BDNF in serum in the Anshen Tongqiao group was higher than that in the routine treatment group(P<0.05),and the levels of IL-1βand TNF-αin the Anshen Tongqiao group were lower than those in the routine treatment group(P<0.05).Before treatment,there was no significant difference being found in the comparison of the scores of Hopkins Verbal Learning Test-Revised(HVLT-R)and Continuous Performance Test(CPT)between the two groups(P>0.05).After treatment,the scores of HVLT-R and CPT in the two groups were increased(P<0.05),and the scores in the Anshen Tongqiao group were higher than those in the routine treatment group(P<0.05).Before treatment,there was no significant difference being found in the comparison of the scores of 36-Item Short Form Health Survey(SF-36)and Bech-Rafaelsen Mania Rating Scale(BRMS)between the two groups(P>0.05).After treatment,the scores of SF-36 in the two groups were increased(P<0.05),and BRMS scores were decreased(P<0.05);SF-36 score in the Anshen Tongqiao group was higher than that in the routine treatment group(P<0.05),and BRMS score in the Anshen Tongqiao group was lower than that in the routine treatment group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Anshen Tongqiao Decoction combined with lithium carbonate for manic episode in patients with bipolar disorder can improve clinical effects,quality of life,attention,and learning ability of patients and reduce the degree of mania,whose mechanism may be related to its adjustments of serum neurotrophin levels and inflammatory reactions.
作者
朱佳
黄宁宁
吴恩辉
ZHU Jia;HUANG Ningning;WU Enhui(Department of Psychiatry,The Second Hospital of Jinhua,Jinhua Zhejiang 321000,China)
出处
《新中医》
CAS
2023年第17期96-101,共6页
New Chinese Medicine
关键词
双相情感障碍
躁狂发作
痰瘀阻滞证
安神通窍汤
碳酸锂
炎症因子
生活质量
Bipolar disorder
Manic episode
Phlegm stasis block type
Anshen Tongqiao Decoction
Lithium carbonate
Inflammatory factors
Quality of life
