苓桂术甘汤治疗抗精神病药物所致代谢综合征疗效分析

Curative effect analysis of Linggui Zhugan Decoction in the treatment of metabolic syndrome induced by antipsychotic drugs

目的观察苓桂术甘汤治疗抗精神病药物诱发代谢综合征(MS)的疗效及安全性。方法选择新乡医学院第二附属医院住院治疗的60例符合抗精神病药物引起的MS患者为研究对象,同时满足痰淤阻证型诊断标准,随机分为观察组和对照组,每组30例。对照组患者给予抗精神病药物治疗;观察组患者在对照组治疗的基础上辅以苓桂术甘汤加减治疗,治疗4周;比较2组患者治疗前后三酰甘油(TG)、高密度脂蛋白(HDL)、空腹血糖、胰岛素、C肽水平及胰岛素抵抗指数(HOMA-IR)。结果与治疗前比较,对照组患者治疗2、4周后TG、空腹血糖、胰岛素、C-肽水平及HOMA-IR升高,HDL降低(P<0.05),观察组患者治疗2、4周后TG、空腹血糖、胰岛素、C-肽水平及HOMA-IR降低,HDL升高(P<0.05);对照组患者治疗4周后血浆胰岛素、C-肽水平及HOMA-IR较治疗2周时升高(P<0.05),观察组患者治疗4周后血浆胰岛素、C-肽水平及HOMA-IR较治疗2周时降低(P<0.05);与对照组比较,观察组患者治疗2、4周后TG、空腹血糖、胰岛素、C-肽水平及HOMA-IR降低,HDL升高(P<0.05)。观察组患者治疗4周后毒副作用量表评分低于对照组(P<0.05)。结论苓桂术甘汤能够改善抗精神病药物所致MS,且具有较好的安全性。

Objective To observe the effectiveness and safety of Linggui Zhugan Decoction in the treatment of metabolic syndrome（ MS） induced by antipsychotics. Methods Sixty MS patients were enrolled who also matched the diagnostic criteria for phlegm stagnation type. These 60 patients who were treated in the Second Affiliated Hospital of Xinxiang Medical University were randomly divided into the observation group and control group,each group included 30 patients. The patients in the observation group were given the treatment of Linggui Zhugan Decoction in addition to antipsychotic treatment,while the patients in the control group were only given antipsychotic treatment. After two weeks or four weeks of treatment,the levels of triglyceride（ TG）,high density lipoprotein（ HDL）,fasting plasma glucose,insulin,C-peptide and insulin resistance index（ HOMA-IR） were compared between the two groups before and after treatment. Results After two weeks or four weeks treatment,the levels of TG,fasting plasma glucose,insulin,C-peptide and HOMA-IR significantly increased and that of HDL decreased significantly in the control group patients compared with those before treatment（ P 0. 05）,while the results in the observation group were opposite（ P 0. 05）. In the control group patients,the levels of insulin,HOMA-IR and C-peptide after four weeks treatment were significantly higher than those after two weeks treatment（ P 0. 05）. However,in the observation group patients,the levels of insulin,HOMA-IR and C-peptide after four weeks treatment were significantly lower than those after two weeks treatment（ P 0. 05）. Compared with the control group,after two weeks or four weeks treatment the levels of TG,fasting plasma glucose,insulin,C-peptide and HOMA-IR decreased significantly in the observation group patients and that of HDL increased significantly（ P 0. 05）. The treatment emergent symptom scale score of the observation group was lower than that of the control group at the end of four weeks（ P 0. 05）. Conclusion Linggui Zhugan Dcoction can improve MS caused by antipsychotics and has good safety.