[1]董男,孟军勤.丁螺环酮联合哌罗匹隆治疗精神分裂症疗效观察[J].新乡医学院学报,2023,40(3):257-261.[doi:10.7683/xxyxyxb.2023.03.012]
　DONG Nan,MENG Junqin.Clinical effect of buspirone combined with piperopirone in the treatment of schizophrenia[J].Journal of Xinxiang Medical University,2023,40(3):257-261.[doi:10.7683/xxyxyxb.2023.03.012]
点击复制

丁螺环酮联合哌罗匹隆治疗精神分裂症疗效观察
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年3期
页码:
257-261
栏目:
临床研究
出版日期:
2023-03-05

文章信息/Info

Title:
Clinical effect of buspirone combined with piperopirone in the treatment of schizophrenia
作者:
董男; 孟军勤
（郑州市第八人民医院精神心理科，河南　郑州　450000）
Author(s):
DONG Nan; MENG Junqin
（Department of Psychosocial， the Eighth People′s Hospital of Zhengzhou，Zhengzhou 450000，Henan Province，China）
关键词:
精神分裂症; 丁螺环酮; 哌罗匹隆; 焦虑; 认知功能
Keywords:
schizophrenia; buspirone; piperopirone; anxiety; cognitive function
分类号:
R971
DOI:
10.7683/xxyxyxb.2023.03.012
文献标志码:
A
摘要:
目的探讨丁螺环酮联合哌罗匹隆治疗精神分裂症的临床疗效。
方法选择郑州市第八人民医院2017年11月至2020年11月收治的92例巩固期精神分裂症患者为研究对象，采用掷硬币法将患者分为观察组（n=46）和对照组（n=46）。所有患者入院后给予心理治疗，在此基础上，对照组患者口服盐酸哌罗匹隆片，观察组患者口服盐酸哌罗匹隆片和盐酸丁螺环酮片，2组患者均治疗3个月。分别于治疗前、治疗3个月时采用阳性与阴性症状量表（PANSS）评估2组患者的症状严重程度，采用蒙特利尔认知评估量表（MoCA）评估2组患者的认知功能，采用焦虑自评量表（SAS）评估2组患者的焦虑程度。分别于治疗前、治疗3个月时采用化学发光法检测2组患者血清脑源性神经营养因子（BDNF）、胶质源性神经营养因子（GDNF）、5-羟色胺（5-HT）水平。采用治疗伴发症状量表（TESS）评估患者不良反应程度，比较2组患者治疗期间不良反应发生率。
结果治疗前2组患者的阴性症状、阳性症状、一般精神病理症状评分比较差异均无统计学意义（P>0.05）。治疗3个月时，2组患者的阴性症状、阳性症状、一般精神病理症状评分均显著低于治疗前（P<0.05）；且观察组患者的阴性症状、阳性症状、一般精神病理症状评分显著低于对照组（P<0.05）。治疗前2组患者的MoCA、SAS评分比较差异均无统计学意义（P>0.05）。治疗3个月时，2组患者的MoCA评分显著高于治疗前，SAS评分显著低于治疗前（P<0.05）；且观察组患者的MoCA评分显著高于对照组，SAS评分显著低于对照组（P<0.05）。治疗前2组患者血清中BDNF、GDNF、5-HT水平比较差异无统计学意义（P>0.05）。 治疗3个月时，2组患者血清中BDNF、GDNF、5-HT水平均显著高于治疗前（P<0.05）；且观察组患者血清中BDNF、GDNF、5-HT水平显著高于对照组（P<0.05）。对照组和观察组患者不良反应发生率分别为8.70%（4/46）、13.04%（6/46），2组患者不良反应发生率比较差异无统计学意义（χ2=0.112，P>0.05）。对照组和观察组患者的TESS评分分别为2.58±0.12、2.62±0.16，2组患者的TESS评分比较差异无统计学意义（P>0.05）。
结论丁螺环酮联合哌罗匹隆治疗精神分裂症可进一步减轻患者的临床症状和焦虑程度，改善认知功能，还可改善患者血清中神经递质水平，且不会增加不良反应。
Abstract:
ObjectiveTo explore the clinical efficacy of buspirone combined with piperopirone in the treatment of schizophrenia.MethodsA total of 92 schizophrenia patients who were in consolidation phase admitted to the Eighth People′s Hospitalof Zhengzhou from November 2017 to November 2020 were selected as the study subjects.The patients were divided into observation group (n=46) and control group (n=46) by coin toss method.All patients were given psychotherapy.Based on this,the patients in the control group took piperopirone hydrochloride tablets orally;and the patients in the observation group took piperopirone hydrochloride tablets and buspirone hydrochloride tablets orally.The patients in both groups were treated for 3 months.The symptom degree of patients in the two groups was evaluated by positive and negative symptoms scale (PANSS),the cognitive function of patients in the two groups was evaluated by Montreal cognitive assessment scale (MoCA) and the anxiety level of patients in the two groups was evaluated by self-evaluation of anxiety scale (SAS) before treatment and after three months of treatment.The serum levels of brain-derived neurotrophic factor(BDNF),glial-derived neurotrophic factor (GDNF) and 5-hydroxytryptamine(5-HT) were measured by chemiluminescence method before treatment and after three months of treatment.The incidence of adverse reactions and the scores of treatment emergent symptom scale (TESS) of patients were compared between the two groups.ResultsThere was no significant difference in the scores of negative symptoms,positive symptoms and general psychopathological symptoms between the two groups before treatment (P>0.05).The scores of negative symptoms,positive symptoms and general psychopathological symptoms of patients in the two groups after three months of treatment were significantly lower than those before treatment(P<0.05).The scores of negative symptoms,positive symptoms and general psychopathological symptoms of patients in the observation group were significantly lower than those in the control group after three months of treatment (P<0.05).There was no significant difference in MoCA and SAS scores of patients between the two groups before treatment (P>0.05).The MoCA score of patients in the two groups after three months of treatment was significantly higher than that before treatment,and the SAS score was significantly lower than that before treatment (P<0.05).The MoCA score of patients in the observation group was significantly higher than that in the control group,and the SAS score was significantly lower than that in the control group after three months of treatment (P<0.05).There wasno significant difference in the serum levels of BDNF,GDNF and 5-HT of patients between the two groups before treatment (P>0.05).The serum levels of BDNF,GDNF and 5-HT of patients in the two groups after three months of treatment were significantly higher than those before treatment(P<0.05).The serum levels of BDNF,GDNF and 5-HT of patients in the observation group were significantly higher than those in the control group after three months of treatment(P<0.05).The incidence of adverse reactions of patients in the control group and the observation group was 8.70% (4/46) and 13.04% (6/46),respectively;there was no significant difference in the incidence of adverse reactions of patients between the two groups（χ2=0.112，P>0.05）.The TESS scores of patients in the control group and the observation group were 2.58±0.12 and 2.62±0.16,respectively;there was no significant difference in the TESS scores of patients between the two groups (P>0.05).ConclusionThe combination of buspirone with piperopirone in patients with schizophrenia further reduces clinical symptoms and anxiety,improves cognitive function and neurotransmitter levels without increasing adverse reactions.

参考文献/References:

［1］　VALSECCHI P，BARLATI S，GAROZZO A，et al.Paliperidone palimitate in short- and long-term treatment of schizophrenia［J］.Riv Psichiatr，2019，54（6）：235-248.
［2］　洪娜，闫丽华，刘富会.礞石滚痰丸联合哌罗匹隆对精神分裂症患者血清生化指标的影响［J］.药物评价研究，2019，42(5):932-935.
HONG N,YAN L H,LIU F H.Effects of Mengshi Guntan Wan combined with perperone on serum biochemical indexes in patients with schizophrenia［J］.Drug Eval Res，2019，42(5):932-935.
［3］　KIM J K,HAN S,JOO M K,et al.Buspirone alleviates anxiety,depression,and colitis;and modulates gut microbiota in mice［J］.Sci Rep,2021,11(1)：22-23.
［4］　郝伟，于欣.精神病学［M］.7版.北京：人民卫生出版社，2013：167-168.
HAO W，YU X.Psychiatry［M］.7th ed.Beijing:People′s Medical Publishing House,2013:167-168.
［5］　DIETZ A G,GOLDMAN S A,NEDERGAARD M.Glial cells in schizophrenia:a unified hypothesis［J］.Lancet Psychiatry,2020,7(3):272-281.
［6］　BIANCOSINO B,PICARDI A,MARMAI L,et al.Factor structure of the Brief Psychiatric Rating Scale in unipolar depression［J］.J Affect Disord,2010,124(3):329-334.
［7］　YUEQIN H,YU W,HONG W,et al.Prevalence of mental disorders in China:a cross-sectional epidemiological study［J］.Lancet Psychiatry,2019,6(3):211-224.
［8］　ARUN S,SCARLETT C,JOHNATHON K,et al.Proceedings #32:effects of cerebellar delta and theta frequency tACS on cognitive performance in patients with schizophrenia［J］.Brain Stimul,2019,12(2):e99-e100.
［9］　HOLLERAN L,KELLY S,ALLOZA C,et al.The relationship between white matter microstructure and general cognitive ability in patients with schizophrenia and healthy participants in the ENIGMA consortium［J］.Am J Psychiatry,2020,177(6):537-547.
［10］　LEUCHT S，CRIPPA A，SIAFIS S，et al.Dose-response meta-analysis of antipsychotic drugs for acute schizophrenia［J］.Am J Psychiatry,2020,177（4）：342-353.
［11］　JINGPING Z,KAIDA J,QINGWEI L,et al.Cost-effectiveness of olanzapine in the first-line treatment of schizophrenia in China［J］.J Med Econ,2019,22(5):439-446.
［12］　GIRDLER S J，CONFINO J E，WOESNER M E.Exercise as a treatment for schizophrenia：a review［J］.Psychopharmacol Bull,2019,49（1）:56-69.
［13］　张莉琳，谭成万，陈华，等.重复经颅磁刺激联合盐酸哌罗匹隆治疗精神分裂症患者疗效观察及对认知功能和生活质量的影响［J］.国际精神病学杂志，2019，46(1):109-112.
ZHANG L L,TAN C W,CHEN H,et al.Effect of repeated transcranial magnetic stimulation combined with Piropilone hydrochloride on cognitive function and quality of life in patients with schizophrenia［J］.J Int Psy,2019，46(1):109-112.
［14］　STRAWN J R,MILLS J A,CORNWALL G J,et al.Buspirone in children and adolescents with anxiety:a review and bayesian analysis of abandoned randomized controlled trials［J］.J Child Adolesc Psychopharmacol,2018,28(1):2-9.
［15］　唐本玲，沈尤兰，田雪入，等.利培酮联合盐酸丁螺环酮片改善精神分裂症患者康复期认知功能［J］.神经损伤与功能重建，2019，14(3):153-155.
TANG B L,SHEN Y L,TIAN X R,et al.Risperidone combined with buspirone hydrochloride tablets improve cognitive function in patients with schizophrenia during rehabilitation［J］.Neur Injury Funct Reconstruct，2019，14(3):153-155.
［16］　SHEIKHMOONESI F,ZARGHAMI M,BAHARI SARAVI S F,et al.A triple-blinded,randomized,placebo-controlled trial to examine the efficacy of buspirone added to typical antipsychotic drugs in patients with chronic schizophrenia［J］.J Res Med Sci,2015,20(2):140-145.
［17］　SI T，LI N，LU H，et al.Impact of paliperidone palmitate one-month formulation on relapse prevention in patients with schizophrenia ：a post-hoc analysis of a one-year，open-label study stratified by medication adherence［J］.J Psychopharmacol,2018,32（6）:691-701.
［18］　BERRY T，ABOHAMZA E，MOUSTAFA A A.Treatment-resistant schizophrenia：focus on the transsulfuration pathway［J］.Rev Neurosci,2020,31（2）:219-232.
［19］　王润泽，任俊赏.涤痰汤联合哌罗匹隆治疗首发精神分裂症30例［J］.西部中医药，2017，30(2):89-90.
WANG R Z,REN J S.Ditan Decoction combined with piropilone in treating 30 cases of first episode schizophrenia［J］.West J Trad Chin Med,2017,30(2):89-90.

相似文献/References:

[1]黄远学,王长虹,苏秀芝,等.77例出院后精神分裂症患者心理调查分析[J].新乡医学院学报,1994,11(03):227.
[2]娄百玉,石玉中,韩巍巍,等.未婚女精神分裂症患者父母的心理分析 [J].新乡医学院学报,1994,11(04):375.
[3]郭素芹,吕路线,郭云,等.一次量氯氮平对精神分裂症患者脑电活动的影响[J].新乡医学院学报,1997,14(02):122.
[4]查彩慧　郭国庆.氯丙嗪氯氮平合用治疗精神分裂症临床疗效评价[J].新乡医学院学报,1999,16(04):311.
[5]郭慧荣,张绍荣． 孙富根.利培酮与氯氮平治疗精神分裂症的临床对照研究[J].新乡医学院学报,2001,18(03):174.
[6]李彩霞,张钰,何艳.冬季和夏季出生的精神分裂患者的临床差异[J].新乡医学院学报,2001,18(05):348.
[7]杜云红,郝以辉,王新友.儿童期精神分裂症预后的影响因素分析[J].新乡医学院学报,2001,18(01):058.
[8]扬世昌,祁富生,张疆丽.利培酮治疗精神分裂症2O例[J].新乡医学院学报,2002,19(02):113.
[9]王长虹,李 晏,贾福军,等.工、Ⅱ型精神分裂症患者血清免疫指标的对照分析[J].新乡医学院学报,2002,19(05):360.
[10]孙富根,杜云红,董瑞兰.精神分裂症患者智商和P3o0电位的关系[J].新乡医学院学报,2002,19(05):376.

更新日期/Last Update: 2023-03-05