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益肝散治疗边缘型人格障碍:一项开放标签研究。

Yi-gan san for the treatment of borderline personality disorder: an open-label study.

作者信息

Miyaoka Tsuyshi, Furuya Motohide, Yasuda Hideaki, Hayashia Maiko, Inagaki Takuji, Horiguchi Jun

机构信息

Department of Psychiatry, Shimane University School of Medicine, 89-1 Enyacho, Izumo 693-8501, Japan.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jan 1;32(1):150-4. doi: 10.1016/j.pnpbp.2007.07.026. Epub 2007 Aug 8.

Abstract

BACKGROUND

Numerous medications have been tested on patients with borderline personality disorder (BPD). Although many of these medications have been demonstrated to be useful, no clear main treatment for BPD has emerged. Despite the efficacy of some of the medicines, acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Chinese herbal medicine yi-gan san (YGS, yokukan-san in Japanese) may be safe and useful in treating behavioral and psychological symptoms in dementia patients. We aimed at evaluating both efficacy and safety of yi-gan san in patients with well-defined BPD.

METHODS

Twenty female outpatients diagnosed with BPD according to DSM-IV criteria and the revised Diagnostic Interview for Borderlines completed a 12-week open-label study with yi-gan san at an average daily dosage of 6.4+/-1.9 g (2.5-7.5 g). Psychometric instruments to assess efficacy included the Brief Psychiatric Rating Scale (BPRS), Hamilton Rating Scales for Depression (HAM-D), Global Assessment of Functioning (GAF), Clinical Global Impression Scale (CGI), and Aggression Questionnaire (AQ).

RESULTS

Most psychometric scale scores exhibited a highly significant improvement (total BPRS; BPRS somatic concern, anxiety, tension, depressive mood, hostility, suspiciousness, motor retardation, uncooperativeness, and excitement subscale; CGI; GAF; AQ) over time.

CONCLUSIONS

In this open-label pilot study, patients treated with YGS showed statistically significant reduction on self-rated and clinician-rated scales. The present findings suggest that yi-gan san might be effective for the treatment of a number of BPD symptoms, including low mood, impulsivity, and aggression.

摘要

背景

众多药物已在边缘型人格障碍(BPD)患者身上进行了测试。尽管其中许多药物已被证明是有用的,但尚未出现明确的BPD主要治疗方法。尽管一些药物有效,但可接受性和副作用已被证明是其使用的障碍。最近的研究表明,传统中药抑肝散(YGS,日语为 yokukan-san)在治疗痴呆症患者的行为和心理症状方面可能是安全且有用的。我们旨在评估抑肝散在明确诊断为BPD的患者中的疗效和安全性。

方法

根据DSM-IV标准和修订后的边缘型人格障碍诊断访谈,20名被诊断为BPD的女性门诊患者完成了一项为期12周的抑肝散开放标签研究,平均每日剂量为6.4±1.9克(2.5 - 7.5克)。评估疗效的心理测量工具包括简明精神病评定量表(BPRS)、汉密尔顿抑郁评定量表(HAM-D)、总体功能评估(GAF)、临床总体印象量表(CGI)和攻击问卷(AQ)。

结果

随着时间的推移,大多数心理测量量表评分均有极显著改善(BPRS总分;BPRS躯体关注、焦虑、紧张、抑郁情绪、敌意、猜疑、运动迟缓、不合作和兴奋分量表;CGI;GAF;AQ)。

结论

在这项开放标签的试点研究中,接受YGS治疗的患者在自评和临床医生评定量表上均有统计学意义的降低。目前的研究结果表明,抑肝散可能对治疗多种BPD症状有效,包括情绪低落、冲动和攻击行为。

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