Miyaoka Tsuyoshi, Furuya Motohide, Kristian Liaury, Wake Rei, Kawakami Kazunori, Nagahama Michiharu, Kawano Kiminori, Ieda Masa, Tsuchie Keiko, Horiguchi Jun
Department of Psychiatry, Shimane University School of Medicine, Izumo, Japan.
Clin Neuropharmacol. 2011 Jan-Feb;34(1):24-7. doi: 10.1097/WNF.0b013e318206785a.
Recent studies indicate that the traditional Japanese herbal medicine yi-gan san (YGS, yokukan-san in Japanese) may be safe and useful for treating behavioral and psychological symptoms in dementia, borderline personality disorder, neuroleptic-induced tardive dyskinesia, and treatment-resistant schizophrenia. Visual hallucinations are common and often distressing consequences of vision loss, particularly in age-related macular degeneration. Charles Bonnet syndrome (CBS) is defined by the triad of complex visual hallucinations, ocular pathology causing visual deterioration, and preserved cognitive status. We aimed at evaluating both the efficacy and safety of YGS in patients with CBS.
Twenty patients diagnosed with CBS were investigated, according to the diagnostic criteria established by Gold and Rabins and Teunisse. Participants were treated in a 4-week open-label study with YGS at an average daily dose of 5.8 ± 2.6 g (2.5-7.5 g). Psychometric instruments used to assess efficacy included the Neuropsychiatric Inventory, hallucination subscale of the Positive and Negative Syndrome Scale, and Clinical Global Impression. No cases of serious adverse events were attributed to the study's drug therapy.
A significant decrease in visual hallucination was observed at 2 and 4 weeks in the Neuropsychiatric Inventory, hallucination subscale of the Positive and Negative Syndrome Scale, and Clinical Global Impression scores.
Yi-gan san may be an effective and safe therapy to control visual hallucination in patients with CBS and should be further tested in double-blind, placebo-controlled trials. Given the design characteristics of this trial, the present findings should be taken cautiously.
近期研究表明，传统日本草药抑肝散（YGS，日语为 yokukan-san）可能对治疗痴呆、边缘型人格障碍、抗精神病药物所致迟发性运动障碍以及难治性精神分裂症的行为和心理症状安全有效。视幻觉是视力丧失常见且常令人苦恼的后果，尤其是在年龄相关性黄斑变性中。查尔斯·博内综合征（CBS）由复杂视幻觉、导致视力减退的眼部病变以及认知状态保留这三联征定义。我们旨在评估抑肝散对CBS患者的疗效和安全性。
根据戈尔德和拉宾斯以及特尼斯确立的诊断标准，对20例诊断为CBS的患者进行了调查。参与者在一项为期4周的开放标签研究中接受抑肝散治疗，平均每日剂量为5.8±2.6克（2.5 - 7.5克）。用于评估疗效的心理测量工具包括神经精神科问卷、阳性和阴性症状量表的幻觉子量表以及临床总体印象量表。未发现严重不良事件归因于该研究的药物治疗。
在神经精神科问卷、阳性和阴性症状量表的幻觉子量表以及临床总体印象量表评分中，在第2周和第4周时视幻觉显著减少。
抑肝散可能是控制CBS患者视幻觉的一种有效且安全的疗法，应在双盲、安慰剂对照试验中进一步测试。鉴于该试验的设计特点，对目前的研究结果应谨慎看待。
