【摘要】 目的探究女性首发精神分裂症因药物引起高催乳素血症患者采用舒肝颗粒和阿立哌唑治疗后的认知功能改变情况。方法选取2016年1月至2018年1月云南省精神病医院收治的女性首发精神分裂症患者192例,均单一使用抗精神病药物治疗,在治疗剂量范围内出现高催乳素血症。采用随机数字表法分为观察组(97例)和对照组(95例),观察组服用舒肝颗粒治疗,对照组服用阿立哌唑治疗,治疗周期12周。治疗前后检测2组患者血清催乳素含量,并使用阳性和阴性症状量表(PANSS)及副反应量表(TESS)、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)对患者的认知功能进行评估。结果观察组患者治疗8、12周血清催乳素水平均明显低于治疗前,对照组患者治疗4、8、12周血清催乳素水平均明显低于治疗前(均P<0.05)。治疗后,2组各项PANSS评分及总分均明显低于治疗前,差异均有统计学意义(均P<0.05)。治疗4、8、12周后观察组TESS量表评分均明显低于对照组[(4.3±2.5)分比(5.0±2.4)分、(4.9±2.9)分比(6.1±3.4)分、(5.0±2.7)分比(8.0±3.5)分],差异均有统计学意义(均P<0.05)。治疗后,观察组WMS中积累、再生、联想、理解得分明显高于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组WCST中完成总应答数评分明显高于对照组,错误应答数评分明显低于对照组(均P<0.05)。结论舒肝颗粒或阿立哌唑治疗均可有效改善女性首发精神分裂症服药所致高催乳素血症患者的认知功能,且舒肝颗粒改善认知功能的效果优于阿立哌唑。更多还原

【Abstract】 Objective To explore the cognitive function changes after Shugan granule and aripiprazole treatment in female first-episode schizophrenia patients with hyperprolactinemia induced by medication. Methods From January 2016 to January 2018, 192 female patients with first-episode schizophrenia in Mental Hospital of Yunnan Province were selected. They were treated with antipsychotics alone, and complicated with hyperprolactinemia within the treatment dose range. Patients were randomly divided into observation group(97 cases) and control group(95 cases). The observation group was treated with Shugan granule, while the control group was treated with aripirazole. The treatment cycle was 12 weeks. The serum level of prolactin(PRL) was detected before and after treatment, and the cognitive function was evaluated by positive and negative symptom scale(PANSS), treatment emergent symptom scale(TESS), Wechsler memory scale(WMS) and Wisconsin card sorting test(WCST). Results The PRL levels of the observation group at 8 and 12 weeks after treatment were significantly lower than those before treatment, while the PRL levels of the control group at 4, 8 and 12 weeks after treatment were significantly lower than those before treatment(all P<0.05). After treatment, the score of each part and total score in PANSS of the two groups were significantly lower than those before treatment, and the differences were statistically significant(all P<0.05). After 4, 8 and 12 weeks of treatment, the TESS score of the observation group was significantly lower than that of the control group[(4.3±2.5) vs(5.0±2.4),(4.9±2.9) vs(6.1±3.4),(5.0±2.7) vs(8.0±3.5)](all P<0.05). After treatment, the scores of accumulation, recognition, association and understanding in WMS of the observation group were significantly higher than those of the control group(all P<0.05). After treatment, the response administered score of the observation group was significantly higher than that of the control group, and the response errors score was significantly lower than that of the control group(both P<0.05). Conclusion Shugan granule or aripiprazole can effectively improve cognitive function of female first-episode schizophrenia patients with hyperprolactinemia induced by medication, and the effect of Shugan granule is better than aripiprazole.更多还原