喹硫平联合谷维素对老年精神分裂症临床疗效及糖脂代谢的影响  

The effects of quetiapine combined with oryzanol on clinical symptoms,blood glucose and lipid metabolism in elderly schizophrenic patients

作　　者：简薇[1] 阮熙 王钰[2] 张浪[2] 

机构地区：[1]成都市第四人民医院老年科,四川成都610031 [2]成都市第四人民医院精神科,四川成都610031

出　　处：《西部医学》2017年第6期826-829,共4页Medical Journal of West China

基　　金：四川省科技支撑计划项目(2015SZ02365)

摘　　要：目的探讨喹硫平联合谷维素对老年精神分裂症患者临床症状及糖脂代谢的影响。方法选择2013年12月至2015年12月来我院精神科就诊的老年精神分裂患者120名,按照完全随机比法随机分为试验组和对照组各60例。试验组实施喹硫平联合谷维素治疗,对照组患者实施喹硫平治疗。采用临床总体印象量表(CGI)、阳性和阴性症状量表(PANSS)、不良反应量表(TESS)对治疗前和治疗后不同时间点患者疗效进行评价;测定治疗前后患者空腹血糖(FBG)、总甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL),评价药物对糖脂代谢的影响。结果治疗后两组患者PANSS得分和CGI得分均显著降低(P<0.05),但试验组患者治疗后同时间点的CGI得分较对照组更低(P<0.05)。两组患者治疗一个疗程后和4个疗程后不良反应得分差异无统计学意义(P>0.05),而治疗两个疗程和3个疗程后试验组患者的不良反应得分低于对照组患者(P<0.05)。两组患者的FBG、TC、TG、HDL和LDL在治疗前后均差异无统计学意义(P>0.05),但4个疗程后,两组患者的空腹血糖水平均显著提高(P<0.05)。结论对老年精神分裂患者同时施用喹硫平和谷维素可以有效改善症状,提高用药安全性。Objective To investigate the effects of quetiapine combined with oryzanol on clinical symptoms and blood glucose and lipid metabolism in elderly schizophrenic patients. Methods 120 elderly schizophrenic patients treated in our hospital from December 2013 to December 2015 were randomly divided into experimental group and control group, 60 cases in each group. The experimental group received quetiapine combined with oryzanol treatment. The control group were treated with quetiapine. The efficacy was evaluated by using the clinical impression scale （CGI）, positive and negative symptom scale （PANSS） and treatment emergent symptom scale （TESS）. fasting blood glucose （FBG）, total triglyceride （TG） ,total cholesterol （TC）, high density lipoprotein （HDL） and low density lipoprotein （LDL）. The effects of drugs on the metabolism of glucose and lipid were observed. Results After the treatment, the PANSS scores and CGI scores of the two groups were significantly decreased （P〈0.05）. The CGI scores of the patients in the experimental group were lower than those in the control group at the same time point after the treatment （P〈0.05）. There was no significant difference between the two groups of patients after one course of treatment and four courses of treatment （P〉 0.05）. The adverse reactions of the treatment group were significantly lower than those of the control group after two courses of treatment and three courses of treatment （P〈0.05）. There were no significant differences in TG, TC ,FBO, HDL and LDL between the two groups before and after treatment （P〉0.05）. After four courses of treatment, the average fasting blood glucose level was significantly increased in the two groups （P〈0.05）. Conclusion The results of this study show that the application of quetiapine and oryzanol can effectively improve symptoms, and improve drug safety.The effect on basal metabolism is relatively small.

关 键 词：喹硫平 谷维素 精神分裂 糖脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]