【摘要】 目的:观察加味苓桂术甘汤用于治疗抗精神病药物所致肥胖症的临床疗效和副作用。方法:选择2004-08/2006-02广州市精神病医院住院及门诊的精神分裂症患者在使用抗精神病药物治疗后出现肥胖者90例。患者按随机抽取序号分为3组,每组30例。加味苓桂术甘汤组,男16例,女14例;年龄(36.41±7.98)岁;病程(7.98±5.71)年。口服加味苓桂术甘汤(主要由茯苓、桂枝、白术、苍术、泽泻、荷叶、远志、番泻叶、法半夏、大腹皮、枳实等组成);苓桂术甘汤组,男14例,女16例;年龄(38.10±8.56)岁;病程(8.58±6.46)年。口服苓桂术甘汤(主要由茯苓、桂枝、白术、苍术、泽泻、荷叶、远志、菖蒲、番泻叶、法半夏等组成);对照组,男15例,女15例;年龄(37.26±8.20)岁;病程(9.63±7.55)年。口服安慰剂(桑叶、菊花等组成)。3组合剂均制成含900g/L生药量,口服2次/d,30mL/次,治疗6周。于治疗前及治疗后第2,4,6周末分别进行简明精神病量表、副反应量表评分及测量体质量。结果:90例患者全部进入结果分析。①3组临床疗效比较:加味苓桂术甘汤组、苓桂术甘汤组及对照组总有效率分别为76.6%(23/30),70%(21/30)和16.6%(5/30);加味苓桂术甘汤组、苓桂术甘汤组总体疗效相当,差异无显著性,均显著高于对照组(P<0.01)。②3组治疗前后体质量变化比较:加味苓桂术甘汤组、苓桂术甘汤组和对照组治疗前体质量差异无显著性[(77.83±6.51),(78.97±7.04),(77.30±7.15)kg,P>0.05];治疗6周后体质量显著低于对照组[(74.50±4.56),(75.07±5.82),(79.13±8.03)kg,P<0.01]。③3组治疗前后简明精神病量表评分变化比较:3组治疗两周后简明精神病量表评分较治疗前均有明显降低(P<0.05或P<0.01);3组各时点比较差异无显著性(P>0.05)。④不良事件及副反应:苓桂术甘汤组,服药后全部患者大便次数增多,1～3次/d,有6例大便次数每日四五次。加味苓桂术甘汤组服药后大便次数增多不明显,对照组无腹泻情况发生。结论:加味苓桂术甘汤是一种有效、安全的治疗抗精神病药物所致肥胖症中药,副反应较小。更多还原

【Abstract】 AIM: To observe the clinical therapeutic and side effect of jiawei lingguizhugan tang on obesity induced by psychoactive drugs. METHODS: Ninety psychotic inpatients and outpatients with obesity induced by psychoactive drugs from Guangzhou Psychiatric Hospital between August 2004 and February 2006 were selected and randomly divided into 3 groups with 30 cases in each group: jiawei lingguizhugan tang group including 16 males and 14 females aged (36.41±7.98) years with an illness course of (7.98±5.71) years: The patients in this group orally took the jiawei lingguizhugan tang (composed of fuling, guizhi, baizhu, cangzhu, zexie, heye, yuanzhi, fanxieye, fabanxia, dafupi, zhishi and so on); lingguizhugan tang group including 14 males and 16 females aged (38.10±8.56) years with an illness course of (8.58±6.46) years: The patients orally took lingguizhugan tang (composed of fuling, guizhi, baizhu, cangzhu, zexie, heye, yuanzhi, chang pu, fanxieye, fabanxia and so on); and control group including 15 males and 15 females aged (37.26±8.20) years with an illness course of (9.63±7.55) years: The patients in this group orally took the placebo (composed of sangye, juhua and so on). The drug mixture of each group contained 900 g/L crude drugs, which was orally taken twice a day, 30 mL each time for a 6-week treatment. The changes were determined by means of the Brief Psychiatric Rating Scale and Treatment Emergent Symptom Scale, and the body mass was recorded before and the 2nd, 4th, 6th weekend after treatment. RESULTS: All 90 patients entered the result analysis. ①Comparison of the therapeutic effects: The total effective rates of jiawei lingguizhugan tang group, lingguizhugan tang group and control group were 76.6% (23/30), 70% (21/30) and 16.6% (5/30) respectively; The efficacy of the jiawei lingguizhugan tang group and the lingguizhugan tang group were similar and better than that of the control group after treatment, but no significant difference between two treatment groups was found (P < 0.01). ②Comparison of the changes in body mass: The difference in body mass among the three groups was not significant before treatment [(77.83±6.51), (78.97±7.04), (77.30±7.15) kg, P > 0.05]; but the body mass of the jiawei lingguizhugan tang group and lingguizhugan tang group were obviously lower than the control group after the 6-week treatment [(74.50±4.56), (75.07±5. 82), (79.13±8.03) kg, P < 0.01]. ③Comparison of the changes in Brief Psychiatric Rating Scale scores: The scores of all groups after 2 weeks treatment were obviously reduced compared with those before treatment (P < 0.05 or P < 0.01); but no obvious difference was found among the three groups at each time point (P > 0.05). ④Adverse events and side effect: All the patients in the lingguizhugan tang group presented an increase frequency in defecation after treatment: 1-3 times daily, and 6 cases with 4-5 times a day. The patients in the jiawei lingguizhugan tang group had no obviously increased frequency of defecation, and no diarrhea was found in the control group. CONCLUSION: Jiawei lingguizhugan tang is an effective and safe herb to treat the obesity induced by psychoactive drugs with fewer side effects.更多还原