Wang Zhongbao, Zheng Yunshao, Fan Yunli, Fan Yunming, Su Xianbiao, Wang Bingrui, Li Jing, Chen Diancai, Sun Fengxia, Li Shen, Ma Jiashu, Li Xianwei, Bai Ludong, Li Ranran
Department of Psychiatry, Jining Medical University, Jining, People's Republic of China.
Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Apr 17;19:929-938. doi: 10.2147/NDT.S408314. eCollection 2023.
Most antipsychotic drugs are dopamine receptor antagonists that usually lead to abnormal increases in prolactin concentrations and the development of hyperprolactinemia (HPRL), which in turn causes sexual dysfunction in patients. Peony-Glycyrrhiza Decoction (PGD) enhanced dopamine D2 receptors (DRD2) and dopamine transporter (DAT) and significantly reversed the expression of DRD2 and DAT. Therefore, we hypothesized that PGD might effectively improve hyperprolactinemia and alleviate sexual dysfunction in patients.
We performed an 8-week randomized controlled study on 62 subjects with schizophrenia who were randomized into two groups. The experimental group was treated with the PGD intervention, and the control group did not receive treatment. The primary outcome indicators were the levels of sex hormones and the total Arizona Sexual Experience Scale (ASEX) score.
There was a significant difference in PRL levels between the two groups at weeks 4 and 8. From the beginning to the end of the experiment, there was a significant increase in PRL levels in the control group, while there was no significant change in the experimental group. The ASEX scale assessed sexual function in both groups, and patients in the experimental group showed an improvement in sexual function at week 8. During the experiment, the two groups found no differences between Positive and Negative Syndrome Scale (PANSS) scores and Treatment Emergent Symptom Scale (TESS) scores.
PGD significantly improved the patient's sexual function but was less effective in reducing prolactin levels and may prevent further increases in prolactin levels.
大多数抗精神病药物是多巴胺受体拮抗剂，通常会导致催乳素浓度异常升高以及高催乳素血症（HPRL）的发生，进而导致患者出现性功能障碍。芍药甘草汤（PGD）可增强多巴胺D2受体（DRD2）和多巴胺转运体（DAT），并显著逆转DRD2和DAT的表达。因此，我们推测PGD可能有效改善高催乳素血症并减轻患者的性功能障碍。
我们对62例精神分裂症患者进行了一项为期8周的随机对照研究，将患者随机分为两组。实验组接受PGD干预，对照组未接受治疗。主要结局指标为性激素水平和亚利桑那性体验量表（ASEX）总分。
两组在第4周和第8周时催乳素水平存在显著差异。从实验开始到结束，对照组催乳素水平显著升高，而实验组无显著变化。ASEX量表评估了两组的性功能，实验组患者在第8周时性功能有所改善。实验期间，两组在阳性和阴性症状量表（PANSS）评分和治疗中出现的症状量表（TESS）评分方面没有差异。
PGD显著改善了患者的性功能，但在降低催乳素水平方面效果较差，可能会阻止催乳素水平进一步升高。
