盐酸小檗碱与二甲双胍对精神分裂症伴发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

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2019, 46(1)
作者
作者单位

天津市安定医院 ;

摘要
通过对盐酸小檗碱及二甲双胍干预精神分裂症代谢综合征的血脂指标及胰岛素抵抗指数的对比,探讨盐酸小檗碱对精神分裂症伴代谢综合征患者调节脂代谢方面的临床疗效,以及与胰岛素抵抗的关系。方法 将89例奥氮平单药治疗的精神分裂症患者随机分为奥氮平联合盐酸小檗碱组(研究组,n=43)和奥氮平联合二甲双胍组(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,并计算稳态模型,评估胰岛素抵抗指数(HOMA-IR)。采用副反应评定量表(TESS)评估药物安全性。结果 研究组和对照组在治疗12周的体重、BMI、TC、TG、APN、LEP、HOMA-IR水平较治疗前显著改善(P均<0.01)。治疗后,两组间比较上述各指标均无显著性差异(P均>0.05)。研究组患者HOMA-IR变化值与TC、TG、LEP变化值均呈显著正相关关系(P均<0.05),HOMA-IR变化值与APN变化值呈显著负相关关系(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 盐酸小檗碱能显著降低精神分裂症伴发代谢综合征患者的体重,改善血脂代谢异常,与二甲双胍疗效相当,这可能与其改善胰岛素抵抗有关。
Abstract
Objective Through the comparision of berberine and metformin in the treatment of lipid index and HOMA-IR in schizophrenia with metabolic syndrome, to investigate the effect of berberine, 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(treated with olanzapine combined with berberine) and 46 control group(treated with olanzapine 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. In addition, the treatment emergent symptom scale (TESS) was assessed adverse reactions. Results Compared with before treatment, both groups had significantly improved in body weight, BMI, TC, TG, APN, LEP, and HOMA-IR in 12th week (P<0.01). All the indices between two groups had no significant difference post-treatment (P>0.05). The HOMA-IR in study group was positively correlated with TC, TG, LEP changing value (P<0.05), and negatively correlated with APN changing value (P<0.05). There were no significant differences on adverse reactions between the two groups (P>0.05). Conclusion Berberine has significant efficacy on weight loss, lipids metabolic abnormalities in patients with schizophrenia and MS, and has the same efficacy as metformin. This maybe associated with insulin resistance.
关键词
精神分裂症;代谢综合征;盐酸小檗碱;二甲双胍;脂代谢
KeyWord
Schizophrenia; Metabolic Syndrome; Berberine; Metformin; Lipid Metabolism
基金项目
页码 92-95
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赵永萍,仇玉莹,李美娟,李建功,刘莹,李洁*. 盐酸小檗碱与二甲双胍对精神分裂症伴发代谢综合征患者调节脂代谢的影响 [J]. 国际精神病学杂志. 2019; 46; (1). 92 - 95.

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