| BackgroundMental disorders are the first burden of illness in China,of them schizophrenia is a severe brain function deficiency disease,its symptoms are complex,heterogeneity is strong,and clinical manifestations are mainly thinking,emotional,behavior disorder as well as the incoordination of mental activity.Antipsychotic drugs have been the preferred treatment for schizophrenia now.Antipsychotic drugs bring about a series of adverse reactions at the same time of improving patients' symptoms.Endocrine disorders are common in female patients,especially hyperprolactinemia,its incidence reaches up to 80% and above reported by some studies.Amenorrhea,lactation,menstrual disorder,sexual dysfunction,osteoporosis etc.due to hyperprolactinemia greatly reduce patients' quality of life and influence treatment compliance.The Chinese and Western medicine have different treatment protocols for hyperprolactinemia,but both advantages and disadvantages.Clinicians don't pay adequate attention to the severity of antipsychotic-induced endocrine disorder in female schizophrenics now,as results in poor treatment compliance and recurrent attacks and brings a heavy burden to society and family.Objective1.To survey the incidence of hyperprolactinemia in female schizophrenics in our hospital primarily.2.To survey the clinical symptoms of hyperprolactinemia and patients' attention to these symptoms.3.To investigate the attention status of psychiatrists to drug induced hyperprolactinemia and its related clinical symptoms in our hospital.4.To observe the therapeutic effect of Chinese patent medicine Wuji Baifeng pills for menoxenia caused by hyperprolactinemia.Methods1.Cross-sectional study:(1)Survey objects: According to the ICD – 10 criteria for schizophrenia 364 female schizophrenics hospitalized in the Second Affiliated Hospital of Xinxiang Medical University from August 1 to 10 2016 were selected as survey objects.(2)Survey content: divided into three parts(1)Surveys of patients' basic information and treatment status included antipsychotic drugs used before admission and at present,pre-admission and last prolactin(PRL)levels,and measures adopted after PRL elevation.(2)Clinical symptoms due to hyperprolactinemia and patients' attentions to were surveyed,clinical symptoms mainly included menstruation,lactation and sexual function status.(3)Surveys of psychiatrists' attentions to hyperprolactinemia and treatment status included that whether doctors were concerned about the increased prolactin caused by antipsychotic drugs,whether drug induced hyperprolactinemia needed to be treated,whether the clinical symptoms caused by drug induced hyperprolactinemia needed to be treated,and treatment for the clinical symptoms of hyperprolactinemia was patient's request or what you thought need to be treated.2.Observation of the therapeutic effect of Wuji Baifeng pills in antipsychotics induced hyperprolactinemia(1)Study objects: 42 patients meeting criteria in cross-sectional investigation were selected and randomly divided into treatment and control group of 21 ones each.(2)Therapeutic methods: the treatment group was plus Wujibaifeng pills based on the original antipsychotic medication,once in the morning and evening,1 pill(9grams)/time;control group treatment plan unchanged.Results1.A total of 364 female schizophrenics were enrolled.Prolactin(PRL)levels were detected in 325 patients on admission and notably heightened in 70.8% of the patients,decreased in 1.9%,only 10.9% of hyperprolactinemia patienta was treated,and prolactin levels significantly lowered in 14 ones after aripiprazole treatment(t=103.9,P<0.01).2.Findings of clinical symptoms induced by hyperprolactinemia and patients' attentions:(1)According to the survey of different age groups,the results showed that the patients of 23~29 years old had the highest rate of attention;attention rates were relatively lower in patients under 16 years of age and over 37,not more than half.(2)14.5%~23.6% of the patients considered hyperprolactinemia need treatment,these patients are more in 23~29 years of age,the patients under 16 years of age and above the age of 37 are more consider not need to treatment.(3)The degrees of patients' concern to abnormal menstruation were relatively higher(35%),lower to lactation(12.7%)and sexual dysfunction(4.1%)respectively.The higher the level of education,the higher the degree of concern to lactation,specialist,undergraduate and above were 61.1% and 68.8% of patients were concern hyperprolactinemia,primary and illiterate were 41.5% and 23.1% of the people concerned,respectively.(4)Finding of the prevalence of clinical symptoms associated with hyperprolactinemia showed that 23.04% of patients developed abnormal menstruation,9.57% lactation,and 10.0% sexual dysfunction.3.Surveys on doctors' attention to hyperprolactinemia and treatment showed that23.7% of doctors thought that hyperprolactinemia didn't need attention,87.3% did that hyperprolactinemia didn't need treatment,34.5% did that clinical symptoms of induced by hyperprolactinemia didn't need treatment,52.7% treated hyperprolactinemia according to patients' needs.4.Differences of curative effects of Six-week Wuji Baifeng pills in treatment of menstruation,endometrial thickness and lactation level from control group had no statistical significances(P>0.05).Conclusion1.The incidence of hyperprolactinemia in female schizophrenics during treatment of antipsychotic drugs female was higher and reached 70.8%.2.The degree of attention to hyperprolactinemia was related to educational levels,the higher the education levels,the higher the degrees of attention;patients with childbearing age(23~29 years)had higher attention to hyperprolactinemia;prolactin levels were higher in patients with lactation.3.Clinical psychiatrists had lower attention to hyperprolactinemia and related clinical symptoms.4.The efficacy of 6 week Wuji Baifeng pills treatment for female schizophrenics with menoxenia caused by schizophrenic hyperprolactinemia wasn't obvious. |
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