摘要
目的 探究符合中医“癫病”诊断的精神分裂症（以阴性症状为主）患者，采用《金匮要略》中小半夏加茯苓汤加减治疗的价值。方法 选取本院收治50例痰湿内阻型精神分裂症患者（时段2023年9月-2025年9月），随机分为两组。对照组（25例）采用常规抗精神病西药（如奥氮平、利培酮）治疗，观察组（25例）在对照组基础上联合小半夏加茯苓汤加减治疗。根据中医证候积分、阳性和阴性症状量表（PANSS）评分、临床疗效及安全性进行评价。结果 观察组治疗后中医证候积分及PANSS阴性症状评分均较对照组下降（P<0.05）。观察组临床总有效率（92.00%）高于对照组（68.00%），（P<0.05）。两组用药不良反应发生率无显著差异（P>0.05）。结论 癫病患者辅助使用小半夏加茯苓汤加减治疗能改善中医证候及核心阴性症状，提高疗效，且安全性良好。
关键词： 癫病；金匮要略；小半夏加茯苓汤
Abstract
Objective To explore the value of using the modified Xiaoshanzhi Fuling Decoction from “The Essentials of the Jingui Classic” for treating schizophrenia patients with “epilepsy” as diagnosed by traditional Chinese medicine (whose main symptoms are negative symptoms). Methods Fifty patients with schizophrenia caused by internal dampness (from September 2023 to September 2025) admitted to our hospital were selected and randomly divided into two groups. The control group (25 cases) was treated with conventional antipsychotic Western drugs (such as olanzapine and risperidone), while the observation group (25 cases) was treated with the combination of Xiao Banxia Jia Fu Ling Decoction modification on the basis of the control group. The evaluation was conducted based on the TCM syndrome score, Positive and Negative Syndrome Scale (PANSS) score, clinical efficacy and safety. Results After treatment, the TCM syndrome scores and PANSS negative symptom scores of the observation group were both lower than those of the control group (P < 0.05). The clinical total effective rate of the observation group (92.00%) was higher than that of the control group (68.00%), (P < 0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05). Conclusion The adjunctive use of Xiao Banxia Jia Fuling Decoction modification in patients with epilepsy can improve the traditional Chinese medicine syndromes and core negative symptoms, enhance the therapeutic effect, and has good safety.
Key words： Schizophrenia (with predominant negative symptoms); Jingui yaolue; Xiao banxia jia fu ling decoction
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