中药治疗抗精神病药物导致肥胖的系统评价和Meta分析  

Systematic evaluation and Meta-analysis of traditional Chinese medicine for the treatment of obesity caused by antipsychotic drugs

作　　者：伦涵蔚 王芝怡 于芮 樊懿萱 李英帅[5] LUN Hanwei;WANG Zhiyi;YU Rui;FAN Yixuan;LI Yingshuai(School of Qi-Huang Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;Respiratory Department,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;School of Life Sciences,Beijing University of Chinese Medicine,Beijing 100029,China;Intensive Care Unit,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;National Institute of TCM Constitution and Preventive Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学岐黄学院,北京100029 [2]北京中医药大学第三附属医院呼吸科,北京100029 [3]北京中医药大学生命科学学院,北京100029 [4]中国中医科学院西苑医院重症医学科,北京100091 [5]北京中医药大学国家体质与治未病研究院,北京100029

出　　处：《现代医学》2025年第4期530-539,共10页Modern Medical Journal

基　　金：国家自然科学基金资助项目(82074291)。

摘　　要：目的:评价中药治疗抗精神病药物导致肥胖的临床疗效。方法:于2024年7月21日,计算机检索知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science共8个数据库,获取相关文献。由2名研究人员独立筛选文献并提取数据,采用Cochrane Collaboration“RoB2.0”工具对纳入的随机对照试验进行质量评价,使用RevMan 5.4软件进行Meta分析。结果:共纳入17项随机对照试验,总样本量为1545例(中药治疗组870例,对照组675例,20例中途退出)。Meta分析结果显示,相比于其他治疗措施,中药能改善患者体重(MD=-4.55,95%CI-7.53~-1.56,P=0.003)、BMI(MD=-1.97,95%CI-3.42~-0.53,P=0.008)和甘油三酯(MD=-0.33,95%CI-0.64~-0.02,P=0.03)。亚组分析显示,中药相比常规空白改善体重(MD=-7.68,95%CI-11.07~-4.29,P<0.01)和BMI(MD=-3.55,95%CI-4.25~-2.84,P<0.01)的疗效更为显著,相比西药升高高密度脂蛋白胆固醇(MD=0.12,95%CI 0.02~0.22,P=0.02)优势明显。结论:中药可能有助于改善抗精神病药物所致精神分裂症患者肥胖的临床症状,调整脂肪代谢水平。Objective:To evaluate the clinical efficacy of traditional Chinese medicine(TCM)in the treatment of antipsychotic drugs-induced obesity.Methods:China National Knowledge Infrastructure,Wanfang database,VIP database,Chinese Biomedical Literature Database,PubMed,Embase,Web of Science and Cochrane Library were searched on July 21,2024.Literature was screened and data extracted independently by two researchers.The Cochrane Collaboration“RoB2.0”tool was used to evaluate the quality of the included randomized controlled trials,and Meta-analysis was performed using RevMan 5.4 software.Results:Seventeen randomized controlled trials were included in this study,with a total sample size of 1545 patients(870 in the trial group,675 in the control group,and 20 dropouts).The results of the Meta-analysis showed that compared with the control group,the TCM group improved body weight(MD=-4.55,95%CI-7.53--1.56,P=0.003),body mass index(BMI)(MD=-1.97,95%CI:-3.42--0.53,P=0.008),Triglyceride(MD=-0.33,95%CI-0.64--0.02,P=0.03).Subgroup analyses revealed that the efficacy of TCM in reducing body weight(MD=-7.68,95%CI-11.07--4.29,P<0.01)and BMI(MD=-3.55,95%CI-4.25--2.84,P<0.01)was more significant than that of conventional blanks,and the advantage of elevating the HDL-C(MD=0.12,95%CI 0.02-0.22,P=0.02)was significant compared to western drugs.Conclusion:TCM may help to improve clinical symptoms of obesity and regulate fat metabolism levels in schizophrenic patients with antipsychotic drug-induced obesity.

关 键 词：精神分裂症 肥胖 抗精神病药物 中药 META分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]