盐酸小檗碱与二甲双胍对精神分裂症伴代谢综合征患者调节脂代谢的影响

Effect of Berberine and Metformin on lipid metabolism in patients with schizophrenia combined with metabolic syndrome

目的探讨盐酸小檗碱和二甲双胍对精神分裂症合并代谢综合征患者调节脂代谢的疗效,以及与胰岛素抵抗的关系。方法将89例奥氮平单药治疗的患者随机分为合并小檗碱组(研究组,n=43)及合并二甲双胍组(对照组,n=46),疗程12周。测定两组患者治疗前后的体重、体质量指数(BMI)、空腹血糖(FPG)、空腹胰岛素(Fins)、胆固醇(TC)、甘油三酯(TG)、脂联素(APN)、瘦素(LEP)水平,并计算胰岛素抵抗指数(HOMA-IR)。应用副反应评定量表(TESS)评估药物安全性。结果两组在治疗后的体重、BMI、TC、TG、APN、LEP、HOMA-IR水平较治疗前显著改善(P均<0.01)。治疗12周,两组间比较上述各指标均无显著性差异(P均>0.05)。研究组HOMA-IR变化值与TC、TG、LEP变化值均呈显著正相关(P均<0.05),与APN变化值呈显著负相关(P<0.05)。两组药物不良反应比较差异均无统计学意义(P均>0.05)。结论盐酸小檗碱能明显降低精神分裂症MS患者的体重,调节脂质代谢异常,与二甲双胍疗效相当,这可能与其改善胰岛素抵抗有关。

Objective To compare the effect of lipids metabolic abnormalities between berberine and metformin in schizophrenia patients with MS,and explore the relationship with insulin resistance. Methods A total of 89 schizophrenia patients with olanzapine treatment were divided into two groups :43 study group(combined with berberine)and46 control group(combined with metformin)for 12 weeks. The body weight,BMI,FPG,Fins,TC,TG,APN,LEP were evaluated before and after the treatment. The homeostasis model assessment for HOMA-IR was calculated.TESS was assessed adverse reactions. Results Compared with the baseline,both groups had significantly improved in body weight,BMI,TC,TG,APN,LEP,and HOMA-IR in 12 th week(P<0.01). There was no significant difference in all the indices between the two groups after the treatment(P>0.05). The HOMA-IR in study group was positively correlated with changes of TC,TG,LEP(P<0.05),and negatively correlated with the change of APN(P<0.05).All adverse reactions between two groups had no significant difference(P>0.05). Conclusion Berberine has significant efficacy on weight,lipids metabolic abnormalities in schizophrenia patients with MS,and has the same efficacy as metformin. Maybe it associates with insulin resistance.