加味苓桂术甘汤治疗奥氮平导致的肥胖以及对血清甘油三酯和脂联素等指标的影响

目的：探讨加味苓桂术甘汤治疗奥氮平导致的肥胖以及对血脂的影响。方法：将189例精神分裂症患者随机分为3组，每组各63例。A组患者单用奥氮平治疗，B组采用辛伐他汀治疗，c组在B组基础上加用加味苓桂术甘汤治疗。比较分析各组的肥胖、血脂等指标变化及不良反应。结果：C组的总有效率为87．3％，显著高于B组73．0％（χ2=4．04，P〈0．05）。治疗后，A组BMI、腰围、WHR及体质量均较治疗前显著上升（P〈0．05），而B、c组较治疗前有所下降，且c组上述指标的下降程度显著优于B组（P〈0．05）；治疗后，A组Tc、TG水平均显著升高，脂联素水平显著下降（P〈0．05）；与治疗前比较，B、C组治疗后TC、TG水平均显著降低，脂联素水平显著升高（P〈0．05）；而C组治疗后Tc、TG水平显著低于B组，且脂联素水平显著高于B组（P〈0．05）；B组、c组均未见肝肾功能异常及其他严重不良反应。结论：加味苓桂术甘汤联合辛伐他汀治疗奥氮平所致肥胖安全、有效，可有效减轻肥胖，改善血脂代谢，提高患者依从性。

Effect of Jiawei Lingui Shugan Decoction for Obesity Induced by Olanzapine and Its Influence to Indicators of Serum Triglyceride and Adiponectin

Objective ： To explore the effect of Jiawei Lingui Shugan Decoction for obesity induced by olanzapine and its influence to indicators of serum triglyceride （TG） and adiponectin. Methods： 169 schizophrenia patients were randomlydivided into three groups. Group A （N=63） was given olanzapine alone, Group B（N =63） was given simvastatin, and Group C （N = 63 ） was given Jiawei Lingui Shugan Decoction combined with simvastatin. The indicators of obesity and blood lipid and adverse effect were observed. Results ： The total effective rate in Group C was 87.5% , which was signifi- candy higher than that in Group B 73.0% （P 〈 0.05）. The BMI, waistline, WHR and body weight in Group A was sig- nificantly increased （P 〈 0.05 ）. The indicators above in Group B and Group C were all improved compared with that be- fore treatment, while they improved more remarkably in Group C than those in Group B （ P 〈 0.05 ）. For the patients in Group A, the levels of TC and TG were increased remarkably, and adiponectin was decreased （ P 〈 0.05 ）. Compared with that before treatment, the indicators of blood lipid in Group B and Group C were all improved （ P 〈 0.05 ） , while compared with Group B, the levels of TC and TG were reduced remarkably, and adiponectin was increased （ P 〈 0.05 ）. There was no liver and kidney dysfunction and other serious adverse effect found in Groups B and Group C. Conclusion： It is effective and safe of combination use of Jiawei Lingui Shugan Decoction and simvastatin. It can contribute to reduce obesity, improve lipid metabolism and patients＇ compliance.