二甲双胍缓释片治疗抗精神病药物所致代谢紊乱的临床效果

The comparative study of metformin extended-release tablets in the treatment of metabolic disorder induced by antipsychotic

目的：研究二甲双胍缓释片对抗精神病药所致代谢紊乱的疗效和安全性。方法：76例应用抗精神病药物所致代谢紊乱的精神分裂症患者随机分为2组，观察组给予二甲双胍缓释片，对照组给予安慰剂，连续观察6个月。于治疗1、3、6个月末监测体质量指数（ BMI）、空腹血糖及总胆固醇（ TC）、三酰甘油（ TG）、低密度脂蛋白（ LDL）、高密度脂蛋白（ HDL）。阳性和阴性症状量表监测病情变化，副反应量表评定不良反应。结果：观察组患者治疗3和6个月末BMI及治疗1、3和6个月末TC、TG与LDL均明显低于治疗前（P〈0.01），而对照组治疗6个月末TC和LDL均较治疗前、治疗1和3个月末升高（P〈0.05～P〈0.01）。2组空腹血糖和HDL治疗前后不同时间差异均无统计学意义（P〉0.05）。2组患者治疗6个月末BMI、TC、TG、LDL及HDL差异均有统计学意义（P〈0.01）；2组治疗前和治疗6个月末阴性症状量表评分差异均无统计学意义（P〉0.05）。2组不良反应均轻微。结论：二甲双胍缓释片治疗抗精神病药引起的代谢紊乱安全有效，且不影响患者的精神症状。

Objective：To study the efficacy and safety of metformin extended-release tablets on the metabolic disorder induced by antipsychotic. Methods：Seventy six schizophrenia patients with metabolic disorder induced by antipsychotic were divided into the treated group and control group randomly for 6 months. Monitor body mass index（BMI）,fasting blood glucose（FBG） and blood lipid （TC,TG,LDL,HDL） at the end of 1,3 and 6 month. The Positive and Negative Symptom Scale（PANSS） and Treatment Emergent symptoms scale（ TESS） were used to measure clinical efficacy. Results：It was decreased that BMI,TC,TG and LDL level at the end of 1 or 3 month in treated group,the differences were statistically significant（P〈0. 01）,but there was no marked changes in the level of HDL and FBG（P〉0. 05）. The differences of BMI,FBG,TG and HDL level were not significant in control group（P〉0. 05）. At the end of 6 month,the differences of BMI,TC,TG,LDL and HDL level were statistically significant between the two groups（P〈0. 01）. Before and after treatment,the scores of PANSS were not statistically significant between the two groups（P〉0. 05）. Adverse reactions in the 2 groups were mild. Conclusions：It is effective and safe that metformin extended-release tablet treatment of metabolic disorder induced by antipsychotic,and does not affect the mental symptoms.