摘要
目的 研究化痰开窍法联合氯氮平治疗精神分裂症(SZ)的临床疗效及其对微小RNA(miRNA)、神经损伤因子的影响.方法 前瞻性选择2021年9月至2023年8月于黑龙江神志医院治疗的SZ患者80例,依据随机数字表法将其分为观察组(n=40)和对照组(n=40).对照组行氯氮平治疗,观察组行化痰开窍法联合氯氮平治疗,两组均治疗4周.于治疗4周后,观察两组临床疗效.对比两组治疗前及治疗4周后激越行为、认知功能[简易视觉空间记忆测验修订版(BVMT-R)评分]、血清miR124、miR-132-3p miRNA水平、血清α-突触核蛋白(α-Syn)、硫酸脱氢表雄酮(DHEAS)水平及不良反应.结果 观察组总有效率为95.00％,高于对照组(75.00％),差异有统计学意义(P＜0.05).治疗4周后,观察组紧张、兴奋、不合作、敌意、冲动控制障碍评分分别为(1.90±0.21)、(2.02±0.23)、(1.73± 0.19)、(1.98±0.22)、(1.79±0.19)分,均低于对照组[(2.89±0.30)、(3.19±0.35)、(2.95±0.32)、(3.14±0.33)、(2.86±0.31)分],差异均有统计学意义(P＜0.05).治疗4周后,观察组3次BVMT-R评分分别为(6.63±0.69)、(9.56±0.98)、(10.64±0.33)分,均高于对照组[(5.78±0.60)、(8.45±0.87)、(9.15±0.93)分],差异均有统计学意义(P＜0.05).治疗4周后,观察组血清miR124、miR-132-3p水平分别为1.25±0.14、1.63±0.18,均低于对照组(1.60±0.18、2.05±0.23),差异均有统计学意义(P＜0.05).治疗4周后,观察组血清α-Syn为(108.46±13.20)ng/L,高于对照组[(89.26±9.09)ng/L],DHEAS 水平为(58.95±6.13)nmol/L,低于对照组[(70.82±7.40)nmol/L],差异均有统计学意义(P＜0.05).观察组不良反应为20.00％,与对照组(25.00％)比较,差异无统计学意义(P＞0.05).结论 化痰开窍法联合氯氮平治疗SZ可抑制患者激越行为,改善其认知功能,降低血清miR124、miR-132-3p水平,避免患者神经功能损伤,疗效显著,安全性高.
Abstract
Objective To study the clinical effect of the treatment of schizophrenia(SZ)by eliminating phlegm and opening orifice meth-od combined with clozapine and its effects on miRNA and nerve injury factors.Methods A total of 80 SZ patients treated in Heilongjiang Shenzhi Hospital from September 2021 to August 2023 were prospectatively selected,and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The control group was treated with clozapine,and the observation group was trea-ted with eliminating phlegm and opening orifice method with clozapine,two groups were treated for 4 weeks.The clinical effect of the two groups were observed.The agitated behavior,Cognitive function[brief visuospatial memory test revised(BVMT-R)score,BVMT-R were performed three times];Serum miRNA levels such as miR124 and miR-132-3p;Serum alpha-Synuclein(a-Syn),dehydroepiandrosterone sulfate(DHEAS)and other nerve damage factors of the two groups before and after 4 week of treatment and adverse reaction were observed.Results The total effective rate of observation group were 95.00％,which were higher than that of control group(75.00％),the difference was statistically significant(P＜0.05).After 4 week of treatment,the scores of tension,excitement,uncooperation,hostility and impulse control disorder in the observation group were(1.90±0.21),(2.02±0.23),(1.73±0.19),(1.98±0.22),(1.79±0.19)scores,respectively,which were lower than those in the control group[(2.89±0.30),(3.19±0.35),(2.95±0.32),(3.14±0.33),(2.86±0.31)scores],and the differences were statistically significant(P＜0.05).The three BVMT-R scores of the observation group were(6.63±0.69),(9.56±0.98)and(10.64±0.33)scores,respectively,which were higher than those of the control group[(5.78±0.60),(8.45±0.87)and(9.15±0.93)scores],and the differences were statistically significant(P＜0.05).The levels serum of miR124 and miR-132-3p in the observation group were 1.25±0.14 and 1.63±0.18,respectively,which were lower than those in the control group(1.60±0.18 and 2.05±0.23),and the differences were statistically significant(P＜0.05).Serum α-Syn in the observation group were(108.46±13.20)ng/L,which was higher than that in the control group[(89.26±9.09)ng/L],and the level of DHEAS was(58.95±6.13)nmol/L,which was lower than that in the control group[(70.82±7.40)nmol/L],and the differences were statistically significant(P＜0.05).The incidence of adverse reactions in the observation group was 20.00％,and there was no statistically significant difference compared to that in the control group(25.00％)(P＞0.05).Conclusion Combined with clozapine in the treatment of SZ can inhibit the agitated behavior of patients,improve their cognitive function,reduce the levels of serum miR124 and miR-132-3p,and avoid the neurological function injury of patients,with significant efficacy and high safety.
基金项目
国家自然科学基金(81973747)
黑龙江省中医药科研项目(ZHY2020-183)
黑龙江省中医药局中医药科研课题(2022)(ZHY2022-050)
维普
万方数据