不同剂量的托吡酯联合奥氮平治疗精神分裂症的效果及对体重指数、糖脂代谢的影响  

Effect of different doses of Topiramate combined with Olanzapine in the treatment of schizophrenia and its influence on body mass index and glucose and lipid metabolism

作　　者：李良[1] 戴雄凯[1] 王轶虎[1] 曾雷 吴瑾瑾[3] 李建华[4] LI Liang;DAI Xiongkai;WANG Tiehu;ZENG Lei;WU Jinjin;LI Jianhua(Department of Psychiatry,Huzhou Third People’s Hospital,Zhejiang Province,Huzhou313000,China;Department of Psychosomatics,Huzhou Third People’s Hospital,Zhejiang Province,Huzhou313000,China;Department of Emergency,Huzhou Third People’s Hospital,Zhejiang Province,Huzhou313000,China;Department of Forensic Expertise,Huzhou Third People’s Hospital,Zhejiang Province,Huzhou313000,China)

机构地区：[1]浙江省湖州市第三人民医院精神科,浙江湖州313000 [2]浙江省湖州市第三人民医院心身科,浙江湖州313000 [3]浙江省湖州市第三人民医院急诊科,浙江湖州313000 [4]浙江省湖州市第三人民医院司法鉴定科,浙江湖州313000

出　　处：《中国医药导报》2023年第14期76-80,共5页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(2018KY787);浙江省湖州市公益应用研究项目(2019GYB45)。

摘　　要：目的探究不同剂量托吡酯联合奥氮平治疗精神分裂症的效果及对体重指数(BMI)、糖脂代谢的影响。方法选取2020年11月至2022年2月浙江省湖州市第三人民医院精神科门诊及住院治疗的120例精神分裂症患者,按随机数字表法将其分为对照组、试验1组、试验2组,各40例。对照组给予奥氮平治疗,试验1组给予托吡酯(100 mg最大剂量)+奥氮平治疗,试验2组给予托吡酯(200 mg最大剂量)+奥氮平治疗,均持续治疗12周。比较三组阳性和阴性症状量表(PANSS)评分、BMI、糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)]水平、安全性。结果治疗前,三组PANSS评分比较,差异无统计学意义(P>0.05)。试验1组与对照组比较:治疗4周时PANSS评分比较,差异无统计学意义(P>0.05);治疗8、12周,试验1组PANSS评分低于对照组,差异有统计学意义(P<0.05)。试验2组与对照组比较:治疗4、8、12周,试验2组PANSS评分低于对照组,差异有统计学意义(P<0.05)。试验1组与试验2组比较:治疗4、8、12周,试验2组PANSS评分低于试验1组,差异有统计学意义(P<0.05)。三组组内比较:与治疗前比较,治疗4、8、12周,三组PANSS评分均降低,差异有统计学意义(P<0.05)。治疗后,试验1组、试验2组BMI、FBG、FINS、TG、LDL-C、TC水平均低于对照组(P<0.05),但试验1组与试验2组各指标比较差异无统计学意义(P>0.05)。三组不良反应总发生率比较,差异无统计学意义(P>0.05);三组感觉异常发生率比较,差异有统计学意义(P<0.05)。结论托吡酯治疗精神分裂症患者能够改善奥氮平引起的体重增加,并调节糖脂代谢,缓解精神症状;200 mg剂量的托吡酯改善效果更明显,但可增加感觉异常发生率。Objective To explore the effect of different doses of Topiramate combined with Olanzapine in the treatment of schizophrenia and its effect on body mass index(BMI)and glucose and lipid metabolism.Methods A total of 120 patients with schizophrenia who underwent outpatient and inpatient treatment in the Department of Psychiatry,the Huzhou Third People’s Hospital from November 2020 to February 2022 were selected and they were divided into control group,experimental group 1,and experimental group 2 according to the random number table method,with 40 patients in each group.The control group was treated with Olanzapine,the experimental group 1 was treated with Topiramate(maximum dose of 100 mg)+Olanzapine,and the experimental group 2 was treated with Topiramate(maximum dose of 200 mg)+Olanzapine for 12 weeks.The scores of positive and negative syndrome scale(PANSS),BMI,and glucose and lipid metabolism indexes(fasting blood glucose[FBG],fasting insulin[FINS],triglyceride[TG],low-density lipoprotein cholesterol[LDL-C],total cholesterol[TC]levels,and safety were compared among the three groups.Results Before treatment,there was no significant difference in PANSS scores among the three groups(P>0.05).Comparison between experiment group 1 and control group:there was no significant difference in PANSS score between experimental group 1 and control group at 4 weeks(P>0.05),the PANSS score of experiment group 1 was lower than that of control group after 8 and 12 weeks of treatment,and the differences were statistically significant(P<0.05).Comparison between experimental group 2 and control group:after 4,8 and 12 weeks of treatment,PANSS score of experimental group 2 was lower than those of control group,and the differences were statistically significant(P<0.05).Comparison between experiment group 1 and experiment group 2:the PANSS score of experiment group 2 were lower than that of experiment group 1 after 4,8 and 12 weeks of treatment,and the differences were statistically significant(P<0.05).Intra-group comparison among the

关 键 词：精神分裂症 托吡酯 奥氮平 体重 糖脂代谢 

分 类 号：R749[医药卫生—神经病学与精神病学]