目的 探討烏靈膠囊聯(lián)合帕利哌酮對精神分裂癥患者血清炎癥因子和神經(jīng)功能的影響。方法 選擇2018年4月— 2019年10月在唐山市第五醫(yī)院就診的精神分裂癥患者82例作為本實(shí)驗(yàn)對象，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對照組和觀察組，每組各41例。對照組口服帕利哌酮緩釋片，首次劑量為3 mg，1周后持續(xù)劑量6 mg，1次/d。觀察組在對照組患者治療的基礎(chǔ)上口服烏靈膠囊，3粒/次，3次/d。兩組患者連續(xù)治療8周。對比兩組的臨床療效，檢測兩組患者治療前后血清因子水平，運(yùn)用陽性和陰性癥狀量表（PANSS）評估患者的病情程度，不良反應(yīng)癥狀量表（TESS）評估患者不良反應(yīng)的發(fā)生狀態(tài)。結(jié)果 治療后，觀察組的總有效率為87.80%，顯著高于對照組的68.29%，兩組差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的白細(xì)胞介素-1β（IL-1β）、白細(xì)胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）均明顯低于治療前（P<0.05），且觀察組的IL-1β、IL-17、TNF-α比對照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的髓鞘堿性蛋白（MBP）、神經(jīng)元特異性烯醇化酶（NSE）明顯降低，腦源性神經(jīng)營養(yǎng)因子（BDNF）明顯升高（P<0.05）；治療后，觀察組的MBP、NSE比對照組低，BDNF比對照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組PANSS評分明顯低于治療前（P<0.05）；治療后，觀察組的PANSS評分比對照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組主要不良反應(yīng)的發(fā)生率與TESS評分比較，差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 烏靈膠囊聯(lián)合帕利哌酮可提高精神分裂癥的療效，減輕患者的臨床癥狀，降低血清炎癥因子的水平，保護(hù)神經(jīng)功能，具有重要臨床研究價(jià)值。

Objective To investigate the effect of Wuling Capsules combined with paliperidone on serum inflammatory factors and nervous function in schizophrenics. Methods A total of 82 schizophrenics in Tangshan Fifth Hospital from April 2018 to October 2019 were randomly divided into control group and observation group, each group had 41 cases. Patients in the control group were po administered with Paliperidone Extended-Release Tablets, the first dose was 3 mg, and the continuous dose was 6 mg after 1 week, once daily. Patients in the observation group were po administered with Wuling Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. The clinical efficacy in two groups was compared, and the serum factor levels were detected before and after treatment. The severity of the patients' illness was assessed by using PANSS, and the occurrence status of the patients' adverse reactions was assessed by using the TESS. Results After treatment, the clinical efficacy in the observation group was 87.80%, which was higher than 68.29% of the control group, the difference was statistically significant (P<0.05). After treatment, the levels of IL-1β, IL-17, and TNF-α in the two groups were significantly lower than those before treatment (P<0.05), and the levels of IL-1β, IL-17, and TNF-α in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05). After treatment, the levels of MBP and NSE in two groups were decreased significantly, but BDNF was increased (P<0.05).After treatment, MBP and NSE levels in the observation group were lower than those in the control group, but BDNF was higher than that in the control group, the difference was statistically significant (P<0.05). There was no statistically significant difference between two groups in the incidence of major adverse reactions and the TESS score. Conclusion Wuling Capsules combined with paliperidone can improve the efficacy of schizophrenia, reduce the clinical symptoms of patients, reduce the level of serum inflammatory factors, and protect the neurological function, has important clinical research value.

R971

衛(wèi)生部醫(yī)藥衛(wèi)生科技項(xiàng)目（13010520111109）；唐山市科技局計(jì)劃項(xiàng)目（101302229）