【摘要】 目的系统评价二甲双胍对氯氮平所致精神分裂症患者体重增加的治疗效果。方法在Cochrane Library,MEDLINE,PubMed,EMBASE,中国生物医学文献、中国知网、万方等数据库检索与二甲双胍用于氯氮平所致体重增加的相关文章,检索时间为从建库至2019年4月。研究组口服氯氮平及二甲双胍治疗,对照组口服氯氮平治疗,使用RevMan 5.3统计学软件进行荟萃分析。结果检索出符合研究的文章12篇,氯氮平治疗之初就开始服用二甲双胍的Meta分析结果显示,研究组的体重及体重指数(BMI)降低情况均优于对照组,差异有统计学意义[体重:MD=-2.13,95%CI(-2.91,-1.35),P<0.05;BMI:MD=-1.04,95%CI(-1.36,-0.73),P<0.05]。口服氯氮平≥1个月给予二甲双胍治疗的Meta分析结果显示,研究组二甲双胍<1000 mg对体重及BMI的减轻效果均优于对照组,差异有统计学意义[体重:MD=-7.87,95%CI(-10.00,-5.74),P<0.05;BMI:MD=-1.67,95%CI(-2.46,-0.89),P<0.05];研究组二甲双胍≥1000 mg对体重及BMI的减轻效果均优于对照组,差异有统计学意义[体重:MD=-5.61,95%CI(-9.02,-2.19),P<0.05;BMI:MD=-1.08,95%CI(-1.65,-0.50),P<0.05]。结论二甲双胍可较好地改善氯氮平所致的体重增加,小剂量的二甲双胍治疗效果优于高剂量。更多还原

【Abstract】 Objective To systematicly evaluate the therapeutic effect of Metformin on weight gain in patients with schizophrenia induced by Clozapine. Methods Articles related to the use of Metformin for weight gain induced by Clozapine were searched in the Cochrane Library, MEDLINE, PubMed, EMBASE, China Biology Medicine, China National Knowledge Infrastructure, Wanfang and other databases from the establishment of the databases to April 2019.The study group received oral Clozapine and Metformin for treatment, and the control group received oral Clozapine for treatment. RevMan 5.3 statistical software was used for Meta analysis. Results A total of 12 articles matching the study were identified. Meta analysis of Metformin at the beginning of Clozapine treatment showed that the reduction of body weight and body mass index(BMI) in the study group were better than those in the control group, and the differences were statistically significant(body weight: MD=-2.13, 95%CI[-2.91,-1.35], P<0.05; BMI: MD=-1.04, 95%CI[-1.36,-0.73],P<0.05). Meta analysis of Metformin treatment with oral Clozapine ≥1 month showed that the reduction effect of Metformin <1000 mg on body weight and BMI in the study group was better than that in the control group, and the difference was statistically significant(body weight: MD=-7.87, 95%CI[-10.00,-5.74], P<0.05; BMI:MD=-1.67, 95%CI[-2.46,-0.89], P<0.05). The reduction effect of Metformin ≥1000 mg on body weight and BMI in the study group was better than that in the control group, and the difference was statistically significant(body weight: MD=-5.61, 95%CI[-9.02,-2.19], P <0.05; BMI: MD =-1.08, 95% CI [-1.65,-0.50], P <0.05). Conclusion Metformin can improve the weight gain induced by Clozapine, and the treatment effect of low dose of Metformin is better than that of high dose.更多还原