改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者的影响

发布时间：2018-09-07 13:42

【摘要】：目的:探讨改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者疗效及对血液生化指标的影响。方法:选自2014年2月—2015年8月武汉市精神卫生中心收治的双相情感障碍躁狂发作患者104例,依据随机数字表法随机分为观察组与对照组,各52例。对照组采用丙戊酸钠缓释片治疗,观察组在对照组基础上结合改良通窍活血汤治疗。两组患者疗程均为8周。结果:观察组总有效率(94.23%)及不同证候有效率(96.00%,93.33%,91.67%)均高于对照组(73.08%,73.91%,77.78%,72.73%)(P0.05);两组患者汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)总分及各因子评分治疗后明显下降(P0.05);观察组HAMD总分及各因子评分治疗后明显低于对照组(P0.05);与治疗前比较,两组患者狂躁量表(Bech-Rafaelsen Mania Rating Scale,BRMS)评分和生活质量综合评定问卷(Generic Quality of Life Inventory,GQL-LI)评分治疗后均明显下降(P0.05);观察组BRMS评分和GQL-LI评分治疗后明显低于对照组(P0.05);两组患者血清白细胞介素-1β(interleukin~(-1)β,IL~(-1)β),白细胞介素-4(interleukin-4,IL-4),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平治疗后明显下降(P0.05);观察组IL~(-1)β,IL-4,TNF-α水平治疗后低于对照组(P0.05);两组患者血浆白蛋白和总胆红素水平治疗后明显增加(P0.05);观察组血浆白蛋白和总胆红素水平治疗后高于对照组(P0.05);观察组不良反应发生率(7.69%)低于对照组(26.92%)(P0.05)。结论:改良通窍活血汤联合丙戊酸盐对双相情感障碍躁狂发作患者疗效明显,可明显降低患者血清IL~(-1)β,IL-4,TNF-α水平,提高血浆白蛋白、总胆红素水平水平,且安全可靠。
[Abstract]:Objective: to investigate the effect of modified Tongqiao Huoxue decoction combined with valproate on bipolar affective disorder patients with manic attack and its effect on blood biochemical indexes. Methods: 104 patients with bipolar affective disorder manic attack were selected from Wuhan Mental Health Center from February 2014 to August 2015. According to the method of random number table, they were randomly divided into observation group and control group, 52 cases in each group. The control group was treated with sodium valproate sustained release tablet, and the observation group was treated with modified Tongqiao Huoxue decoction on the basis of control group. The course of treatment was 8 weeks. Results: the total effective rate (94.23%) and the effective rate of different syndromes (96.00% and 93.33%) in the observation group were higher than those in the control group (73.08%) (P 0.05), the total score of the Hamilton Depression scale (Hamilton Depression Scale,HAMD) and the scores of the various factors in the observation group decreased significantly (P0.05), while the total score of the observation group was significantly lower than that of the control group (73.08%) (P0.05). After treatment, it was significantly lower than that in the control group (P0.05). The scores of mania scale (Bech-Rafaelsen Mania Rating Scale,BRMS) and quality of life (Generic Quality of Life Inventory,GQL-LI) in both groups decreased significantly after treatment (P0.05), the BRMS score and GQL-LI score in observation group were significantly lower than those in control group (P0.05). The levels of interleukin-1 尾 (interleukin~ (-1) 尾 til ~ (-1) 尾), interleukin-4 (interleukin-4,IL-4) and tumor necrosis factor- 伪 (TNF- 伪) decreased significantly after treatment (P0.05), the levels of IL~ (-1) 尾 -IL-4TNF- 伪 in the observation group were lower than those in the control group (P0.05), the plasma albumin and total bilirubin levels in the two groups were significantly increased after treatment (P0.05). The levels of plasma albumin and total bilirubin in the group were higher than those in the control group (P0.05), and the incidence of adverse reactions in the observation group (7.69%) was lower than that in the control group (26.92%) (P0.05). Conclusion: modified Tongqiao Huoxue decoction combined with valproate has obvious curative effect on bipolar affective disorder patients with manic attack. It can obviously reduce the level of serum IL~ (-1) 尾 -IL-4TNF- 伪, increase plasma albumin and total bilirubin level, and is safe and reliable.
【作者单位】：武汉市精神卫生中心;武汉市中医医院;深圳市康宁医院;
【基金】：深圳市卫生和人口计划生育委员会立项(B2010286)
【分类号】：R749.4

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