【摘要】 目的验证二甲双胍与行为干预单一或联合治疗抗精神病药所致的体质量增加及糖代谢紊乱的疗效。方法将抗精神病药所致体质量增加≥10%的128例精神分裂症患者随机分为四组:二甲双胍(750 mg/d)联合行为干预组(以下简称 A 组,32例);二甲双胍(750 mg/d)组(以下简称B组,32例);行为干预联合安慰剂组(以下简称 C 组,32例);安慰剂对照组(以下简称 D 组,32例);治疗观察期均为12周。四组患者于治疗前及治疗后第4,8,12周末测定空腹血糖、胰岛素、身高、体质量、腰围,计算体质量指数(BMI)及胰岛素抵抗指数(IRI)并进行比较。结果 (1)A、B、C 组患者治疗后的体质量、BMI、空腹血糖、空腹胰岛素及 IRI 均明显低于治疗前(P<0.05);D 组患者的体质量、BMI、腰围、空腹胰岛素、IRI 治疗后均明显高于治疗前(P<0.05)。(2)治疗4周末,A 组与 B 组体质量、BMI 的下降程度相同,但均明显高于 C 组。治疗12周末,体质量、BMI 的下降程度以 A 组最高,其次为 B 组和 C 组。治疗后各时点,A 组与 B 组的空腹胰岛素、IRI 的下降程度相同,均明显高于C组。结论二甲双胍与行为干预单一或联合治疗均能有效减轻抗精神病药所致的体质量增加及胰岛素抵抗,二甲双胍联合行为干预的疗效最好。单用二甲双胍与二甲双胍联合行为干预治疗缓解抗精神病药引起的胰岛素抵抗的疗效相同。更多还原

【Abstract】 Objective To test the efficacy of behavioral intervention(BI)and metformin alone and in combination for antipsychotic-induced weight gain and glucose metabolism dysfunction.Methods One hundred and twenty eight schizophrenic patients who had weight gain more than 10%of their pre- pretreatment body weight were divided into one of four 12-week individual treatments:BI plus mefformin (750 mg/d),metformin(750 mg/d),BI or placebo.The height,body weight,waist circumference,and the fasting blood glucose and insulin were measured at baseline and at week 4,week 8,and week 12.In addition,the body mass index(BMI)and insulin resistance index(IRI)were calculated.Results After treatment,the weight,BMI,waist circumference,insulin,fasting glucose and IRI levels decreased significantly in the BI plus mefformin,metformin and BI groups and increased in the placebo group.At week 4,the decreases in weight and BMI values were not significantly different between BI plus metformin and metformin groups but were significantly lesser in the BI group.At week 8 and 12,the decreases of weight and BMI levels from high to low were as follows:BI plus metformin,meformin and BI.At week 4,8 and 12,the decreases of insulin and IRI levels were not significantly different between BI plus metformin and metformin groups but were significantly lesser in the BI group.Conclusions Behavior intervention and metformin alone and in combination have efficacy for antipsychotic-induced weight gain,in which the combination therapy shows the best effect on weight loss,and could simultaneously improve the insulin sensitivity.更多还原