二甲双胍联合运动疗法对抗精神病药致糖脂代谢紊乱患者血抵抗素和脂联素水平的影响
이갑쌍고연합운동요법대항정신병약치당지대사문란환자혈저항소화지련소수평적영향
The therapeutic efficacy of metformin combined with exercise therapy in the treatment of antipsychotic induced glucose and lipid metabolism disorder
  • 万方数据
    中国医药 중국의약
    CHINA MEDICINE
    2014年 4期 502-505 ,共4页

    张玉胜%贾继敏%张玉香

    장옥성%가계민%장옥향

    糖脂代谢紊乱%抗精神病药%二甲双胍%运动疗法 糖脂代謝紊亂%抗精神病藥%二甲雙胍%運動療法
    당지대사문란%항정신병약%이갑쌍고%운동요법
    Lipid metabolism%Antipsychotics%Metformin%Exercise therapy
    目的 探讨二甲双胍联合运动疗法对抗精神病药致糖脂代谢紊乱患者血抵抗素和脂联素水平的影响.方法 选择山东省滨州市人民医院诊治的200例精神分裂症患者,完全随机分对照组(100例)和研究组(100例).对照组在持续使用抗精神病药物的同时采用二甲双胍治疗,研究组在对照组治疗基础上联合运动疗法,比较2组患者治疗前及治疗12周后体质量、腰围、空腹及餐后2h血糖、血脂谱、血抵抗素、胰岛素抵抗指数、糖化血红蛋白以及脂联素水平.结果 对照组治疗前体质量、腰围、空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇分别为(65 ±8)kg、(84 ±5) cm、(7.2±1.5) mmol/L、(10.8±2.2) mmol/L、(7.8±0.6)％、(6.3±2.6)、(2.5±0.3)mmol/L、(6.2±1.0) mmol/L、(0.7±0.2)mmol/L、(3.4±0.4)mmol/L,治疗后分别为(63±6)kg、(83 ±4)cm、(6.5 ± 1.3) mmol/L、(7.8±0.6)mmol/L、(6.5±0.4)％、(3.5±0.7)、(2.2±0.3)mmol/L、(5.6±0.9)mmol/L、(1.0±0.3)mmol/L、(2.6±0.3)mmol/L.研究组治疗前体质量、腰围、空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇分别为(65 ±8) kg、(84 ±5)cm、(7.3±1.6) mmol/L、(10.6±2.3) mmol/L、(7.9±0.6)％、(6.4±2.5)、(2.6 ±0.3) mmol/L、(6.3±1.1) mmol/L、(0.7±0.2)mmol/L、(3.3±0.4)mmol/L,治疗后分别为(58±6)kg、(80 ±4)cm、(5.7±1.2) mmol/L、(7.3±0.5)mmol/L、(6.1±0.4)％、(2.9±0.6)、(1.8±0.3)mmol/L、(4.9±0.8)mmol/L、(1.3±0.3)mmol/L、(2.3±0.3)mmol/L,研究组治疗12周后,体质量、腰围、空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇明显低于对照组治疗后和本组治疗前,高密度脂蛋白胆固醇高于对照组治疗后和本组治疗前,差异均有统计学意义(均P＜0.05).2组患者治疗前血抵抗素、脂联素等指标比较差异无统计学意义[对照组分别为(45±13)、(30±10)μg/L,研究组分别为(45±13)、(30±10) μg/L,均P＞0.05].治疗12周后,研究组患者血抵抗数、脂联素等脂肪细胞因子明显低于对照组治疗后[分别为(35±8)μg/L比(43±8)μg/L、(22 ±9) μg/L比(28±9) μg/L,均P＜0.05].结论 二甲双胍在影响糖代谢和胰岛素分泌、减轻胰岛素抵抗的同时,可通过降低血抵抗素、脂联素等脂肪细胞因子而产生的作用,运动疗法可减轻体质量,缓解胰岛素抵抗,联合治疗的效果优于单用二甲双胍.
    목적 탐토이갑쌍고연합운동요법대항정신병약치당지대사문란환자혈저항소화지련소수평적영향.방법 선택산동성빈주시인민의원진치적200례정신분렬증환자,완전수궤분대조조(100례)화연구조(100례).대조조재지속사용항정신병약물적동시채용이갑쌍고치료,연구조재대조조치료기출상연합운동요법,비교2조환자치료전급치료12주후체질량、요위、공복급찬후2h혈당、혈지보、혈저항소、이도소저항지수、당화혈홍단백이급지련소수평.결과 대조조치료전체질량、요위、공복혈당、찬후2h혈당、당화혈홍단백、이도소저항지수、삼선감유、총담고순、고밀도지단백담고순、저밀도지단백담고순분별위(65 ±8)kg、(84 ±5) cm、(7.2±1.5) mmol/L、(10.8±2.2) mmol/L、(7.8±0.6)％、(6.3±2.6)、(2.5±0.3)mmol/L、(6.2±1.0) mmol/L、(0.7±0.2)mmol/L、(3.4±0.4)mmol/L,치료후분별위(63±6)kg、(83 ±4)cm、(6.5 ± 1.3) mmol/L、(7.8±0.6)mmol/L、(6.5±0.4)％、(3.5±0.7)、(2.2±0.3)mmol/L、(5.6±0.9)mmol/L、(1.0±0.3)mmol/L、(2.6±0.3)mmol/L.연구조치료전체질량、요위、공복혈당、찬후2h혈당、당화혈홍단백、이도소저항지수、삼선감유、총담고순、고밀도지단백담고순、저밀도지단백담고순분별위(65 ±8) kg、(84 ±5)cm、(7.3±1.6) mmol/L、(10.6±2.3) mmol/L、(7.9±0.6)％、(6.4±2.5)、(2.6 ±0.3) mmol/L、(6.3±1.1) mmol/L、(0.7±0.2)mmol/L、(3.3±0.4)mmol/L,치료후분별위(58±6)kg、(80 ±4)cm、(5.7±1.2) mmol/L、(7.3±0.5)mmol/L、(6.1±0.4)％、(2.9±0.6)、(1.8±0.3)mmol/L、(4.9±0.8)mmol/L、(1.3±0.3)mmol/L、(2.3±0.3)mmol/L,연구조치료12주후,체질량、요위、공복혈당、찬후2h혈당、당화혈홍단백、이도소저항지수、총담고순、삼선감유、저밀도지단백담고순명현저우대조조치료후화본조치료전,고밀도지단백담고순고우대조조치료후화본조치료전,차이균유통계학의의(균P＜0.05).2조환자치료전혈저항소、지련소등지표비교차이무통계학의의[대조조분별위(45±13)、(30±10)μg/L,연구조분별위(45±13)、(30±10) μg/L,균P＞0.05].치료12주후,연구조환자혈저항수、지련소등지방세포인자명현저우대조조치료후[분별위(35±8)μg/L비(43±8)μg/L、(22 ±9) μg/L비(28±9) μg/L,균P＜0.05].결론 이갑쌍고재영향당대사화이도소분비、감경이도소저항적동시,가통과강저혈저항소、지련소등지방세포인자이산생적작용,운동요법가감경체질량,완해이도소저항,연합치료적효과우우단용이갑쌍고.
    Objective To investigate the therapeutic efficacy of mefformin combined with exercise therapy in the treatment of antipsychotic induced glucose and lipid metabolism disorder.Methods All 200 cases of mental hospital of schizophrenia patients were chosen and randomly divided into control group (100 cases,the continued use of antipsychotic drugs and by metformin treatment) and study group (100 cases,on the basis of the control group combined with exercise therapy).Body mass,waist circumference,fasting and 2 h postprandial blood glucose (FBG,2 h PG),lipid profile,serum resistin,insulin resistance index (IR),glycosylated hemoglobin (HbA1 c) and adiponectin in two groups of patients before and after treatment were compared.Results The control group before treatment,body mass,waist circumference,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,insulin resistance index,triacylglycerol,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol were (65 ± 8) kg,(84 ± 5) cm,(7.2 ± 1.5) mmol/L,(10.8 ± 2.2)mmol/L,(7.8 ±0.6)％,(6.3 ±2.6),(2.5 ±0.3)mmol/L,(6.2 ± 1)mmol/L,(0.7 ±0.2)mmol/L,(3.4± 0.4)mmol/L,after treatment were (63 ± 6) kg,(83 ± 4) cm,(6.5 ± 1.3) mmol/L,(7.8 ± 0.6)mmol/L,(6.5±0.4)％,(3.5 ±0.7),(2.2±0.3)mmol/L,(5.6±0.9)mmol/L,(1.0±0.3)mmol/L,(2.6 ±0.3)mmol/L; the study group before treatment,body mass,waist circumference,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,insulin resistance index,three triacylglycerols,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol were (65 ± 8) kg,(84 ± 5) cm,(7.3 ± 1.6)mmol/L,(10.6 ±2.3)mmol/L,(7.9 ±0.6)％,(6.4 ±2.5),(2.6 ±0.3) mmol/L,(6.3 ± 1.1) mmol/L(0.7 ± 0.2) mmol/L,(3.3 ± 0.4) mmol/L,after treatment were (58 ± 6) kg,(80 ± 4) cm,(5.7±l.2)mmol/L,(7.3±0.5)mmol/L,(6.1 ±0.4)％,(2.9±0.6),(1.8±0.3)mmol/L,(4.9± 0.8)mmol/L,(1.3 ±0.3)mmol/L,(2.3 ±0.3) mmol/L,The study group after 12 weeks of treatment,body mass,waist circumference,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin,insulin resistance index,total cholesterol,triacylglycerol,low density lipoprotein cholesterol breakdown was lower than the control group,high density lipoprotein cholesterol was higher than the control group,the difference was statistically significant (P ＜ 0.05).Before treatment,there was no significant difference in the 2 groups of patients with serum resistin and adiponectin [control group was (45 ± 13),(30 ± 10) μg/L; study group was (45 ± 13),(30 ± 10) μg/L,P ＞0.05].After 12 weeks of treatment,blood resistance number,adiponectin fat cells factor in the study group was significantly lower than the control group after treatment [(35 ± 8) μg/L vs (43 ± 8) μg/L,(22 ± 9) μg/L vs (28 ± 9) μg/L,P ＜ 0.05].Conclusion Combined with exercise therapy,metformin can balance the fat cell factor and improve insulin function.
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