托吡酯治疗伴有糖脂代谢异常的精神分裂症患者的临床研究  

Clinical effects of topiramate on schizophrenic patients with abnormal glucose and lipid metabolism

作　　者：焦清艳[1] 刘晓华[1] 左津淮[1] 刘媛媛[1] 

机构地区：[1]天津市安定医院,天津300222

出　　处：《天津药学》2018年第1期56-58,共3页Tianjin Pharmacy

摘　　要：目的:探讨托吡酯治疗伴有糖脂代谢异常的精神分裂症患者的疗效和安全性。方法:将70例符合纳入标准的精神分裂症患者随机分为研究组和对照组,研究组在单一稳定剂量抗精神病药物治疗基础上联合托吡酯治疗,起始剂量为25 mg/d,1周内逐渐加量至100 mg/d。对照组在单一稳定剂量抗精神病药物治疗基础上联合生活干预模式。在治疗前和治疗12周末比较两组患者的血糖、血脂指标。采用阳性和阴性症状量表(PANSS)、依从性量表(MARS)评估疗效,副反应量表(TESS)评估不良反应。结果:共完成65例。治疗前和治疗12周末两组患者临床疗效比较差异无统计学意义(P>0.05)。治疗后研究组空腹血糖(FBG)、餐后2 h血糖(2 h PPG)、甘油三酯(TG)均低于对照组,高密度脂蛋白(HDL)水平、MARS量表评分高于对照组,差异均有统计学意义(P<0.05)。结论:伴有糖脂代谢异常的精神分裂症患者,联用托吡酯治疗能降低其糖脂异常风险,优于生活干预方式。Objective: To investigate the efficacy and safety of topiramate in the treatment of schizophrenia patients with abnormal glucose and lipid metabolism. Methods: Seventy patients with schizophrenia were randomly divided into the study group and the control group. The study group was treated with topiramate on the basis of the treatment with a single stable dose of antipsychotic drug. Topiramate was given from an initial dose of 25 mg/d to 100 mg/d within one week. The control group was treated with a single antipsychotic drug at a stable dose in addition to life style intervention. Blood glucose and lipid levels were measured and compared between the two groups at the beginning of the treatment and on week 12 after the treatment. The adverse effects were assessed by the positive and negative symptom scale( PANSS),the compliance scale( MARS),and the side effects scale( TESS).Results: A total of 65 cases completed the study. There was no significant difference in clinical curative effects between the two groups 12 weeks after treatment( P > 0. 05). After treatment,fasting blood glucose( FBG),postprandial blood glucose( 2 h PPG) and triglyceride( TG) were lower than those in the control group,High density lipoprotein( HDL) levels,and the MARS scale was higher than the control group( P < 0. 05). Conclusion: Treatment with topiramate in patients with schizophrenia and abnormal glucose and lipid metabolism is superior to life style intervention,reducing the risk of abnormal glucose and lipid metabolism.

关 键 词：托吡酯 生活干预 糖脂代谢异常 精神分裂症 

分 类 号：R971.41[医药卫生—药品]