文章摘要
二陈汤合桃红四物汤治疗非典型抗精神病药物所致痰瘀互结型代谢综合征的临床研究
A placebo-controlled study on the treatment of atypical antipsychotic drug related Phlegm-Blood stasis Type metabolic syndrome with Erchen decoction and Taohong Siwu Decoction
投稿时间:2021-03-01  修订日期:2021-05-10
DOI:
中文关键词: 二陈汤  桃红四物汤  痰瘀互结  代谢综合征  非典型抗精神病药物  精神分裂症  血脂  精神症状
英文关键词: Erchen decoction and taohongsiwu decoction  Phlegm and blood stasis  Metabolic syndrome  Atypical antipsychotics  
基金项目:
作者单位邮编
孙峰俐 浙江省立同德医院浙江省精神卫生中心 310012
虞芳 浙江省立同德医院浙江省精神卫生中心 
任志斌 浙江省立同德医院浙江省精神卫生中心 
蒋永红 浙江省湖州市第三医院 
钱敏才 浙江省湖州市第三医院 
方向明 浙江省义乌市精神卫生中心 
王乃信 浙江省肿瘤医院 
邢葆平 浙江省立同德医院浙江省精神卫生中心 
金卫东 浙江省立同德医院浙江省精神卫生中心 310012
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中文摘要:
      [目的]观察二陈汤合桃红四物汤对非典型抗精神病药物所致痰瘀互结型代谢综合征以及精神症状的影响。[方法]选择2018年6月1日至2020年5月31日在浙江省精神卫生中心住院且符合精神分裂症、代谢综合征且中医辨证属于痰瘀互结证型诊断标准的146例患者,按照2:1的随机方法分组,研究组98例予非典型抗精神病药物联合二陈汤合桃红四物汤加减治疗,对照组48例予非典型抗精神病药物联合中药安慰剂治疗,并于治疗前、治疗后1月末、2月末、3月末分别评定阳性症状和阴性症状评定量表(positive and negative symptom scale,PANSS)和副作用反应量表(Treatment emergent symptom scale,TESS), 测量血压、体重、腰围、臀围,测试空腹血糖、糖化血红蛋白、高密度脂蛋白、低密度脂蛋白、甘油三酯、胆固醇。[结果]与对照组比较,治疗前研究组收缩压、舒张压均无显著性差异(P>0.05),研究组治疗3月后舒张压显著低于对照组(P<0.05)。与对照组相比,研究组臀围、身体质量指数(body mass index,BMI)、体重治疗前无显著差异(P>0.05),治疗前后均无明显变化(P>0.05)。与对照组相比,研究组腰围治疗前无显著差异(P>0.05),治疗后3月末,明显小于对照组(P<0.05)。与对照组相比,研究组治疗前血糖和糖化血红蛋白无显著差异,研究组和对照组组内血糖和糖化血红蛋白指标比较,差异均无统计学意义(P>0.05),糖化血红蛋白在治疗3个月末则显著低于对照组(P<0.05)。与对照组相比,研究组胆固醇、甘油三脂和低密度脂蛋白以及高密度脂蛋白无显著差异(P>0.05),治疗3月末,胆固醇、甘油三脂和低密度脂蛋白指标显著低于对照组,差异均有统计学意义(P<0.05)。与对照组比较,研究组治疗前精神症状无显著差异,治疗3月末普通症状显著低于对照组,有统计学差异(P<0.05)。与对照组比较,研究组TESS治疗前后均无(P>0.05)。[结论]二陈汤合桃红四物汤可以改善非典型抗精神病药物所致痰瘀互结型代谢综合征患者的舒张压、腰围、糖化血红蛋白、胆固醇、甘油三脂和低密度脂蛋白指标,也可以改善这类患者情绪。
英文摘要:
      [Objective] To observe the effects of Erchen decoction and Taohongsiwu decoction on phlegm blood stasis syndrome of metabolic syndrome related to atypical antipsychotics and mental symptoms. [Methods] 146 schizophrenic patients,who hospitalized in Zhejiang province mental health from 1,Jan 2018 to 1, Jan 2020, and met the all diagnostic criteria of phlegm and blood stasis syndrome and metabolic syndrome were randomly divided into study and control group according to 2:1. The study group consist of 98 patients treated by combination of atypical antipsychotic drug and Erchen decoction and Taohongsiwu decoction.The control group consist of 48 patients treated by atypical antipsychotic drug and TCM placebo.PANSS(positive and negative symptom scale) and TESS(Treatment emergent symptom scale) were assessed before treatment, at the end of first month, second month and third month after treatment, Blood pressure, weight, waist circumference, hip circumference, blood glucose, glycosylated hemoglobin, high-density lipoprotein, low-density lipoprotein, triglyceride and cholesterol were also measured at same four timepoint. [Results] Compared to control group,the both systolic and diastolic blood pressure of study group are not different before treatment,and diastolic blood pressure decreased significantly after treatment at third month end(P < 0.05).Compared to control group, hip circumference,body mass index (BMI),body weight are not significant different in before and after treatment (P > 0.05). Compared to control group,the waist circumference of study group are not different before treatment (P > 0.05),and lower significantly after treatment at third month end(P < 0.05).Compared to control group,the blood glucose and glycosylated hemoglobin of study group are not different before treatment,and glycosylated hemoglobin lower significantly after treatment at third month end(P < 0.05).Compared to control group,the levels of cholesterol, triglyceride , low density lipoprotein and high density lipoprotein of study group are not different before treatment(P > 0.05),and the levels of cholesterol, triglyceride , low density lipoprotein are lower significantly after treatment at third month end(P < 0.05).Compared to control group,the mental symptoms of the study group are not significantly different(P > 0.05),the general symptoms were significantly lower after treatment at end of the third month, (P < 0.05)..Compared to control group, TESS in study group are not significant before and after (P > 0.05). [Conclusion] Erchen decoction and Taohongsiwu decoction are both beneficial to the treatment of diastolic blood pressure,waist circumference,glycosylated hemoglobin,cholesterol, triglyceride and low density lipoprotein in metabolic syndrome of phlegm and blood stasis syndrome induced by atypical antipsychotics, and to the improvement of such patients' emotion.
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