标题：养血清脑颗粒联合帕罗西汀对急性精神分裂症合并抑郁患者脑源性神经营养因子表达的影响

      作者：周耀明 1，陆峥 2，马长林 1    1.上海市嘉定区精神卫生中心，上海 201823；2.上海同济大学附属同济医院，上海 200065

      卷次： 2019年30卷7期

      【摘要】 目的 研究养血清脑颗粒联合帕罗西汀对急性精神分裂症合并抑郁患者的脑源性神经营养因子(BDNF)表达的影响。方法 选取上海市嘉定区精神卫生中心2016年6月至2017年6月间收治的急性精神分裂症合并抑郁患者112例，采用随机数表法将其分为对照组和观察组，每组56例。所有患者均予以奥氨平片治疗，在此基础上对照组患者口服帕罗西汀治疗，观察组患者辅以口服养血清脑颗粒联合帕罗西汀治疗，均连续治疗8周。比较两组患者的抑郁及精神病症状改善效果及不良反应，同时比较治疗前后两组患者的BDNF水平、血清急性时相反应蛋白[C反应蛋白(CRP)、铜蓝蛋白(CER)、α1-酸性糖蛋白(AAG)、转铁蛋白(TRF)]水平。结果 观察组患者的治疗总有效率为96.43%，明显高于对照组的76.79%，差异有统计学意义(P<0.05)；治疗后2周、4周和8周，观察组患者的BPRS评分和HAMD评分均明显低于对照组，差异均具有统计学意义(P<0.05)；治疗后观察组患者的BDNF水平为(44.02±9.41) ng/mL，明显高于对照组的(33.17±9.33) ng/mL，CRP水平为(3.76±3.84) mg/L，明显低于对照组的(6.42±3.18) mg/L，CER水平为(284.20±38.29) mg/L，明显低于对照组的(300.46±40.63) mg/L，AAG水平为(0.53±0.11) mg/L，明显低于对照组的(0.71±0.14) mg/L，TRF水平为(2.92±0.41) mg/L，明显高于对照组的(2.74±0.52) mg/L，以上各项指标比较差异均具有统计学意义(P<0.05)；治疗期间，观察组患者的不良反应发生率为33.93%，明显低于对照组的62.50%，差异具有统计学意义(P<0.05)。结论 养血清脑颗粒联合帕罗西汀可有效治疗急性精神分裂症合并抑郁及改善患者精神症状，提高患者脑源性神经生长因子水平的表达，调控机体急性时相反应蛋白平衡，安全可靠。
      【关键词】 养血清脑颗粒；急性精神分裂症；抑郁；脑源性神经营养因子；临床疗效
      【中图分类号】 R749.3 【文献标识码】 A 【文章编号】 1003—6350（2019）07—0846—04

Effect of Yangxueqingnao granule combined with paroxetine on the expression of brain-derived neurotrophicfactor in patients with acute schizophrenia and depression.
ZHOU Yao-ming 1, LU Zheng 2, MA Chang-lin 1. 1.Shanghai Jiading Mental Health Center, Shanghai 201823, CHINA; 2. Tongji Hospital of Tongji University, Shanghai200065, CHINA
【Abstract】 Objective To study the effect of Yangxueqingnao granule combined with paroxetine on the expres-sion of brain-derived neurotrophic factor (BDNF) in patients with acute schizophrenia and depression. Methods FromJune 2016 to June 2017, 112 patients with acute schizophrenia complicated with depression were selected from theShanghai Jiading Mental Health Center and were randomly divided into control group and observation group, with 56cases in each group. All patients were treated with olanzapine tablets, on the basis of which patients in the control groupreceived oral paroxetine; and patients in the observation group received oral Yangxueqingnao granule combined with par-oxetine. Both were treated continuously for 8 weeks. The improvement effects and adverse reactions of depression andpsychotic symptoms were compared between the two groups. The levels of BDNF and the serum acute phase reactionproteins (C-reactive protein [CRP], ceruloplasmin [CER], α 1-acid glycoprotein [AAG], transferrin [TRF]) were com-pared between the two groups before and after treatment. Results The total effective rate of treatment in the observa-tion group was 96.43%, which was significantly higher than 76.79% in the control group (P<0.05). At 2 weeks, 4 weeks,and 8 weeks after treatment, the BPRS scores and HAMD scores of the observation group were significantly lower thanthose of the control group (P<0.05). After treatment, in the observation group, the level of BDNF was (44.02±9.41) ng/mL,which was significantly higher than (33.17 ± 9.33) ng/mL in the control group; the CRP level was (3.76 ± 3.84) mg/L,which was significantly lower than (6.42±3.18) mg/L in the control group; the CER level was (284.20±38.29) mg/L,which was significantly lower than (300.46±40.63) mg/L in the control group; the AAG level was (0.53±0.11) mg/L,which was significantly lower than (0.71±0.14) mg/L in the control group; the TRF level was (2.92±0.41) mg/L, whichwas significantly higher than (2.74±0.52) mg/L in the control group (P<0.05). During treatment, the incidence of adversereactions in the observation group was 33.93% , which was significantly lower than 62.50% in the control group (P<