二甲双胍治疗奥氮平所致首发精神分裂症女性患者体质量增加的疗效及安全性分析

Clinical Efficacy and Safety of Metformin for Treating Weight Gain Induced by Olanzapine in First-Episode Patients with Schizophrenia

目的观察二甲双胍对奥氮平所致首发精神分裂症女性患者体质量增加的干预效果。方法将确诊的70例首发住院精神分裂症女性患者按随机数字表法分为干预组和对照组,各35例。干预组患者采用二甲双胍+奥氮平治疗,对照组患者采用奥氮平治疗,比较基线和8周末两组患者体质量、体质量指数(BMI),空腹血糖(FBG)和副反应量表(TESS)评分的变化,所有评定均由精神科人员盲法操作。结果治疗8周末,共完成64例(91.43%),两组脱落率无差异(P>0.05);干预组和对照组体质量相比[(-1.7±3.1)kg比(0.6±3.2)kg],BMI相比[(-0.6±2.1)kg/m^2比(1±2.6)kg/m^2]和FBG相比[(-0.1±0.1)mmol/L比(0.1±0.3)mmol/L],差异均有统计学意义(P<0.05);对照组体质量增加3例,干预组恶心3例。结论二甲双胍对奥氮平所致首发精神分裂症女性患者体质量增加的干预疗效佳,且安全性好。

Objective To observe the intervention effect of metformin for treating weight gain induced by olanzapine in first-episode female patients with schizophrenia. Methods Totally 70 female inpatients with schizophrenia were randomly divided into the interventiongroup and the control group, 35 cases in each group. The intervention group was given metformin combined with olanzapine, while the control group was given olanzapine. The changes in body weight, body mass index （ BMI ） , fasting blood glucose （ FBG ） and treatment emergent symptom scale （ TESS ） scores were compared between the two groups at baseline and after 8 weeks, all assessments were performed with blind manipulation by psychiatric staffs. Results After 8 weeks of treatment, 64 cases （ 91. 43% ） were completed, and there was no difference in the rate of abscission between the two groups （ P 〉 0. 05 ） . There were significant difference in body weight [（ -1.7±3.1）kg vs.（0.6±3.2）kg],BMI[（ -0.6±2.1）kg/m2 vs.（1±2.6）kg/m2],FBG[（ -0.1±0.1）mmol/L vs.（0.1± 0. 3）mmol/L] between intervention group and control group（ P 〈 0. 05）. The adverse events in the control group and the intervention group were weight gain （ 3 cases ） and vomiting （ 3 cases ） . Conclusion The intervention effect and safety of metformin for treating weight gain induced by olanzapine in first-episode female patients with schizophrenia were good.