CAJ | 학술논문

目的：探讨奥氮平联合二甲双胍治疗抑郁性精神障碍合并2型糖尿病(T2MD)患者的临床疗效。方法选取2013年1月至2014年6月本院收治的124例精神障碍合并T2MD患者为研究对象，根据随机数字表将患者分为观察组和对照组各62例，两组患者均给予二甲双胍降糖治疗(0.5 g/次，3次/d)，对照组在此基础上给予盐酸帕罗西汀(20 mg/次，1 d/次)治疗，观察组则给予奥氮平治疗(1.25 mg/次，1次/d)，两组患者均持续用药4周。对比分析两组患者治疗前后空腹血糖(FBG)、餐后2 h血糖(2 h FPG)、糖化血糖蛋白(HbAlc)、降糖药物剂量及抑郁、焦虑等精神症状的变化。结果观察组治疗后FBG、2 hFPG、HbAlc水平显著低于对照组(P<0.05)。观察组治疗1、2、4周后汉密尔汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05)。观察组低血糖、头晕、恶心呕吐发生率低于对照组(P<0.05)。结论奥氮平联合降糖药物能有效改善精神障碍合并T2MD患者血糖水平，缓解患者抑郁症状，副反应发生率低，安全有效。
목적：탐토오담평연합이갑쌍고치료억욱성정신장애합병2형당뇨병(T2MD)환자적림상료효。방법선취2013년1월지2014년6월본원수치적124례정신장애합병T2MD환자위연구대상，근거수궤수자표장환자분위관찰조화대조조각62례，량조환자균급여이갑쌍고강당치료(0.5 g/차，3차/d)，대조조재차기출상급여염산파라서정(20 mg/차，1 d/차)치료，관찰조칙급여오담평치료(1.25 mg/차，1차/d)，량조환자균지속용약4주。대비분석량조환자치료전후공복혈당(FBG)、찬후2 h혈당(2 h FPG)、당화혈당단백(HbAlc)、강당약물제량급억욱、초필등정신증상적변화。결과관찰조치료후FBG、2 hFPG、HbAlc수평현저저우대조조(P<0.05)。관찰조치료1、2、4주후한밀이한밀이돈억욱량표(HAMD)평분균저우대조조(P<0.05)。관찰조저혈당、두훈、악심구토발생솔저우대조조(P<0.05)。결론오담평연합강당약물능유효개선정신장애합병T2MD환자혈당수평，완해환자억욱증상，부반응발생솔저，안전유효。
Objective To investigate the clinical efficacy of olanzapine combined with metformin in the treatment of depressive mental disorders in patients with type 2 diabetes mellitus (T2DM). Methods One hundred and twenty-four patients with mental disorders complicated with T2MD from January 2013 to June 2014 were divided into the observation group and control group, each with 62 cases. The two groups were both given metformin for hypo-glycemic therapy (0.5 g/time, 3 times/d). The control group received paroxetine hydrochloride (20 mg/time, 1 time/d), and the observation group were treated with olanzapine (1.25 mg/time, 1 time/d). Two groups were both treated for four weeks. The blood glucose (FBG), 2 h postprandial blood glucose changes (2 hFPG), glycated bood protein (HbAlc), antidiabetic drug dose and depression, anxiety and other psychiatric symptoms of two groups before and after treatment were compared. Results The levels of FBG, 2 hFPG, HbAlc after treatment were significantly lower than the control group (P<0.05). The Han Mill Hamilton Depression Scale (HAMD) of the observation group after 1, 2, 4 weeks were significantly lower than the control group (P<0.05). The levels of hypoglycemia, dizziness, nausea and vomiting of observation group were significantly lower than in the control group (P<0.05). Conclusion Olanzapine and hypoglycemic drugs can improve the blood glucose levels in patients with mental disorders complicated with T2MD, relieve symptoms of depression, lower incidence of side effects, with good safety and efficacy.