二甲双胍联合利培酮治疗精神分裂症合并代谢综合征患者的效果研究  

Study on effect of metformin combined with risperidone in the treatment of schizophrenia with metabolic syndrome

作　　者：刁婷婷 荣小荣 王慧 DIAO Ting-ting;RONG Xiao-rong;WANG Hui(Liaocheng Fourth People's Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市第四人民医院,252000

出　　处：《中国实用医药》2024年第4期37-41,共5页China Practical Medicine

摘　　要：目的研究二甲双胍联合利培酮治疗精神分裂症合并代谢综合征的临床效果。方法88例精神分裂症合并代谢综合征患者,随机分为对照组与研究组,各44例。对照组患者以利培酮治疗,研究组患者以利培酮联合二甲双胍治疗。对比两组患者治疗前后脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、糖代谢指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)]、阳性与阴性症状量表(PANSS)评分,生存质量评分,不良反应发生情况。结果治疗后,研究组患者的TC、TG、LDL-C分别为(4.80±0.36)、(2.42±0.52)、(2.10±0.37)mmol/L,均低于对照组的(5.04±0.45)、(3.07±0.63)、(2.68±0.41)mmol/L,差异具有统计学意义(P<0.05)。治疗后,研究组患者的FBG、HbA1c、HOMA-IR分别为(6.83±1.15)mmol/L、(6.71±1.21)%、(5.45±0.89),均低于对照组的(8.43±1.49)mmol/L、(7.94±1.76)%、(6.97±0.96),差异具有统计学意义(P<0.05)。治疗后,研究组患者的阴性症状、阳性症状、一般精神病理评分分别为(12.31±3.50)、(16.10±4.06)、(13.15±2.40)分,均低于对照组的(15.61±4.53)、(19.41±4.55)、(17.49±4.22)分,差异具有统计学意义(P<0.05)。研究组患者心理功能、独立性、环境适应、生理功能评分分别为(7.36±1.21)、(7.63±2.31)、(6.49±2.01)、(7.41±1.06)分,均高于对照组的(6.69±1.01)、(6.74±1.37)、(5.77±1.23)、(6.76±1.72)分,差异具有统计学意义(P<0.05)。研究组患者的不良反应发生率9.09%明显低于对照组的27.27%,差异具有统计学意义(P<0.05)。结论精神分裂症合并代谢综合征患者采用二甲双胍联合利培酮治疗能够有效改善患者糖脂代谢指标,有利于减轻患者精神分裂症状,提升生存质量,同时不引发严重不良反应,保证治疗安全。Objective To study the clinical effect of metformin combined with risperidone in the treatment of schizophrenia with metabolic syndrome.Methods A total of 88 schizophrenic patients with metabolic syndrome were randomly divided into a control group and a study group,with 44 cases in each group.The control group was treated with risperidone,and the study group was treated with risperidone and metformin.Both groups were compared in terms of lipid metabolism indexes[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)],glucose metabolism indexes[fasting blood glucose(FBG),glycated hemoglobin(HbA1c),Hemostatic Model Assessment of Insulin Resistance Index(HOMA-IR)],Positive and Negative Symptom Scale(PANSS)score and quality of life score before and after treatment,and occurrence of adverse reactions.Results After treatment,TC,TG and LDL-C in the study group were(4.80±0.36),(2.42±0.52)and(2.10±0.37)mmol/L,which were lower than those of(5.04±0.45),(3.07±0.63)and(2.68±0.41)mmol/L in the control group,and the differences were statistically significant(P<0.05).After treatment,FBG,HbA1c and HOMA-IR in the study group were(6.83±1.15)mmol/L,(6.71±1.21)%and(5.45±0.89),which were lower than those of(8.43±1.49)mmol/L,(7.94±1.76)%and(6.97±0.96)in the control group,and the differences were statistically significant(P<0.05).After treatment,the scores of negative symptoms,positive symptoms and general psychopathology of the study group were(12.31±3.50),(16.10±4.06)and(13.15±2.40)points,which were lower than those of(15.61±4.53),(19.41±4.55)and(17.49±4.22)points of the control group.The differences were statistically significant(P<0.05).The scores of psychological function,independence,environmental adaptation and physiological function in the study group were(7.36±1.21),(7.63±2.31),(6.49±2.01)and(7.41±1.06)points,which were higher than those of(6.69±1.01),(6.74±1.37),(5.77±1.23)and(6.76±1.72)points in the control group,and the differences were statistically significant(P<0.05).Th

关 键 词：精神分裂症 代谢综合征 二甲双胍 利培酮 不良反应 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]