摘要
目的探讨帕利哌酮联合右佐匹克隆片对精神分裂症合并失眠患者神经营养因子及神经递质的影响。方法选择2020年1-12月于宁波市康宁医院就诊的精神分裂症合并失眠患者60例进行前瞻性研究,采用随机数字表法将纳入研究的病例分为观察组和对照组各30例。对照组患者服用右佐匹克隆片+利培酮片进行治疗,观察组患者服用右佐匹克隆片+帕利哌酮缓释片进行治疗,连续治疗8周。采用阳性与阴性症状量表(PANSS)评估患者精神分裂症严重程度,比较两组患者治疗前后PANSS变化;参考匹兹堡睡眠质量指数(PSQI)评估并比较两组患者治疗前后睡眠情况;比较两组患者治疗前后血清脑源性神经营养因子(BDNF)、神经营养因子3(NT-3)、神经生长因子(NGF)含量以及血浆中多巴胺(DA)和5-羟色胺(5-HT)含量。结果治疗后,观察组PANSS评分为(52.71±6.41)分,明显低于对照组的(60.34±6.25)分,差异有统计学意义(t=4.668,P<0.05);观察组PSQI评分为(8.83±2.43)分,明显低于对照组,差异有统计学意义(t=4.567,P<0.05);观察组治疗后血清BDNF[(4 752.79±136.27)ng/L]、NT-3[(173.64±15.88)ng/L]、NGF[(39.14±2.23)ng/L]均明显高于对照组[(4 417.85±138.54)ng/L、(150.06±15.49)ng/L、(37.51±2.17)ng/L],差异均有统计学意义(t=9.441、5.822、2.869,均P<0.05);观察组治疗后血浆DA[(70.25±6.41)ng/L]和5-HT[(43.42±7.11)ng/L]均明显高于对照组[(63.44±6.03)ng/L、(35.59±6.89)ng/L],差异均有统计学意义(t=4.238、4.332,均P<0.05)。结论帕利哌酮联合右佐匹克隆片对精神分裂症合并失眠患者疗效较好,可有效改善精神分裂和失眠症状,提高神经营养因子含量,调节神经递质水平,从而改善患者精神状态。
Objective To investigate the effects of paliperidone combined with dexzopiclone on plasma neurotrophic factors and neurotransmitters in schizophrenic patients with insomnia.Methods Sixty schizophrenic patients with insomnia who received treatment in Ningbo Kangning Hospital,China between January 2020 and December 2020 were included in this study.They were randomly assigned to receive treatment with either dexzopiclone tablets combined with risperidone tablets(control group,n=30)or paliperidone tablets combined with dexzopiclone tablets(observation group,n=30)for 8 successive weeks.The Positive and Negative Syndrome Scale(PANSS)was used to evaluate the severity of schizophrenia.Change in PANSS score post-treatment relative to pre-treatment was compared between the control and treatment groups.The Pittsburgh Sleep Quality Index(PSQI)score was used to evaluate sleepiness before and after treatment.Change in PSQI score post-treatment relative to pre-treatment was compared between the control and treatment groups.Before and after treatment,serum brain-derived neurotrophic factor,neurotrophic factor 3,nerve growth factor,dopamine and serotonin levels were compared between the control and observation groups.Results After treatment,PANSS score in the observation group was significantly lower than that in the control group[(52.71±6.41)points vs.(60.34±6.25)points,t=4.668,P<0.05].PSQI score in the observation group[(8.83±2.43)points]was significantly lower than that in the control group(t=4.567,P<0.05).After treatment,serum brain-derived neurotrophic factor,neurotrophic factor 3 and nerve growth factor levels in the observation group were(4752.79±136.27)ng/L,(173.64±15.88)ng/L,and(39.14±2.23)ng/L,respectively,which were significantly higher than those in the control group[(4417.85±138.54)ng/L),(150.06±15.49)ng/L,(37.51±2.17)ng/L,t=9.441,5.822,2.869,all P<0.05].After treatment,serum dopamine and serotonin levels in the observation group were(70.25±6.41)ng/L and(43.42±7.11)ng/L,respectively,which were significantly higher than those in the control group[(63.44±6.03)ng/L,(35.59±6.89)ng/L,t=4.238,4.332,both P<0.05).Conclusion Paliperidone tablets combined with dexzopiclone tablets exhibit good efficacy in the management of schizophrenic patients with insomnia.The combined therapy can effectively reduce the symptoms of schizophrenia complicated by insomnia,increase serum neurotrophic factor level,regulate serum neurotransmitter level,and thereby improve the mental state of patients.
作者
苏健军
敬攀
徐永明
Su Jianjun;Jing Pan;Xu Yongming(Third Ward,Department of Psychiatry,Ningbo Kangning Hospital,Ningbo 315200,Zhejiang Province,China;Department of Traditional Chinese Medicine,Ningbo Kangning Hospital,Ningbo 315200,Zhejiang Province,China;Department of Early Intervention,Ningbo Kangning Hospital,Ningbo 315200,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2021年第12期1856-1860,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
精神分裂症
入睡和睡眠障碍
脑源性神经营养因子
神经营养因子3
多巴胺
血清素
帕利哌酮
右佐匹克隆片
Schizophrenia
Sleep initiation and maintenance disorders
Brain-derived neurotrophic factor
Neurotrophic factor 3
Dopamine
Serotonin
Paliperidone
Dexzopiclone tablets
