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当归承气汤联合碳酸锂对躁狂发作患者 认知功能影响的对照研究
赵静龙彬朱丽萍张建明吴海苏卢卫红
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摘要:
目的 评价当归承气汤联合碳酸锂治疗对躁狂发作患者认知功能障碍的疗效。方法 将 123 例患者随机分成当归承气汤组41 例、碳酸锂组42 例和当归承气汤联合碳酸锂组(联合组)40 例,随 访8 周。应用Young 氏躁狂量表(YMRS)及可重复的成套神经心理状态测量(RBANS)在治疗前后评估 患者的精神症状、认知功能。结果 (1)3 组间YMRS 差值差异有统计学意义(F=8.683,P < 0.001)。当 归承气汤组及碳酸锂组的YMRS 差值低于联合组(t=-4.577,P< 0.001;t=-3.309,P=0.004)。(2)治疗后, 3 组在RBANS 总分及其各因子分均升高(均P< 0.01)。3 组间两两比较,RBANS 总分和视觉空间分比较 当归承气汤组较联合组低(t=-24.500,P < 0.001;t=-5.644,P=0.016),语言功能分比较碳酸锂组低于联 合组(t=-4.009,P=0.028),延迟回忆分比较联合组高于当归承气汤组(t=-9.130,P=0.001)、碳酸锂组(t= -6.447,P=0.015)。(3)联合组的视觉空间差值与YMRS 分差值呈轻度正相关(r=0.326,P=0.046)。当归承 气汤组视觉空间差值与YMRS 分差值呈轻度正相关(r=0.310,P=0.045),延时回忆差值与YMRS 分差值呈 轻度正相关(r=0.370,P=0.017)。结论 当归承气汤联合碳酸锂治疗改善躁狂发作患者认知功能,且与 精神症状的改善相关性不明显。
关键词:  当归承气汤  躁狂发作  认知功能
DOI:10.3969/j.issn.1009-6574.2019.04.004
基金项目:上海市科学技术委员会科研计划项目(17401932600,16401934700,11DZ1972800)
A comparative study of the effect of Danggui-Chengqi Decoction combined with lithium carbonate onthe cognitive function in patients with manic episodes
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Abstract:
Objectives To evaluate the efficacy of Danggui-Chengqi Decoction combined with lithium carbonate in the treatment of cognitive dysfunction in patients with manic episodes. Methods A total of 123 patients were randomly divided into 41 cases of Danggui-Chengqi Decoction group, 42 cases of -4.009,P=0.028); the delayed recall score was higher in the combined group than that in the Danggui-Chengqi Decoction group( t=-9.130,P=0.001) and the lithium carbonate group( t=-6.447,P=0.015).( 3) The visualspatial difference and the difference in YMRS score were slightly positively correlated in the combined group (r=0.326,P=0.046). In the Danggui-Chengqi Decoction group, there was a slight positive correlation between the visual-spatial difference and the difference in the YMRS score( r=0.310,P=0.045), and between the delayed recall difference and the difference in the YMRS score( r=0.370,P=0.017). Conclusions Danggui-Chengqi Decoction combined with lithium carbonate treatment can improve the cognitive function of patients with manic episodes, and the correlation with the improvement of mental symptoms is not strong. lithium carbonate group and 40 cases of Danggui-Chengqi Decoction combined with lithium carbonate group (combined group). All patients were followed up for 8 weeks. Psychiatric symptoms and cognitive function were assessed before and after treatment using the Young Mania Rating Scale( YMRS) and Repeatable Battery for the Assessment of Neuropsychological Status( RBANS). Results (1) The difference of YMRS between the three groups was statistically significant( F=8.683,P<0.001). The difference of YMRS between the Danggui- Chengqi Decoction group and the lithium carbonate group was lower than that of the combined group( t=-4.577, P<0.001;t=-3.309,P=0.004).( 2) After treatment, the total scores of RBANS and its factor scores increased in all three groups( P<0.01). In pairwise comparison, the total scores of RBANS and visual-spatial were lower in Dangui-Chengqi Decoction group than those in the combined group( t=-24.500,P < 0.001;t=-5.644, P=0.016); the verbal ability score in the lithium carbonate group was lower than that in the combined group( t=
Key words:  Danggui-Chengqi Decoction  Mania episode  Cognitive function

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