1.上海中医药大学附属龙华医院中医传统治疗部(上海 200032)
2.上海市第五人民医院中医科(上海 200240)
3.上海交通大学医学院附属精神卫生中心,上海市精神心理疾病临床医学研究中心,上海市中医神志病研究所(上海 200030)
张欣宇,女,硕士研究生,主要从事针灸治疗代谢性疾病临床与研究工作
赵海音,主任医师,硕士研究生导师; E-mail:freshair1966@126.com
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张欣宇,陆云圻,沈含冰,等.针刺联合常规疗法治疗抗精神病药物相关代谢综合征的临床观察[J].上海中医药杂志,2022,56(1):58-62.
ZHANG Xinyu,LU Yunqi,SHEN Hanbing,et al.Clinical observation of acupuncture combined with conventional therapy for treatment of antipsychotic drug⁃induced metabolic syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(1):58-62.
张欣宇,陆云圻,沈含冰,等.针刺联合常规疗法治疗抗精神病药物相关代谢综合征的临床观察[J].上海中医药杂志,2022,56(1):58-62. DOI: 10.16305/j.1007-1334.2022.2104042.
ZHANG Xinyu,LU Yunqi,SHEN Hanbing,et al.Clinical observation of acupuncture combined with conventional therapy for treatment of antipsychotic drug⁃induced metabolic syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(1):58-62. DOI: 10.16305/j.1007-1334.2022.2104042.
目的,2,观察针刺联合常规疗法治疗抗精神病药物相关代谢综合征的临床疗效。,方法,2,将93例气虚痰结型精神分裂症合并代谢综合征患者随机分为对照组(46例)和治疗组(47例),对照组采用常规药物治疗及生活方式干预,治疗组在对照组治疗措施的基础上加用针刺治疗,两组疗程均为3个月,治疗结束后继续随访6个月。观察比较世界卫生组织生存质量测定量表(简化版)(WHO-QOL-BREF)、功能大体评定量表(GAF)、临床疗效总评量表(病情严重程度部分)(CGI-SI)、副反应量表(TESS)评分,腰围、臀围、体质量指数、血压等一般情况,以及血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)等实验室指标的变化情况。,结果,2,①试验过程中,治疗组、对照组各脱落1例,最终完成试验者91例,其中治疗组46例、对照组45例。②试验过程中,对照组患者WHO-QOL-BREF、GAF、CGI-SI、TESS评分,体质量指数、腰围、臀围、收缩压、舒张压,以及相关实验室指标均无明显变化(,P,>0.05)。③治疗组患者3个月后GAF评分及WHO-QOL-BREF的生理领域、心理领域评分升高(,P,<0.05),CGI-SI、TESS评分降低(,P,<0.05),血脂相关实验室指标改善(,P,<0.05);6个月后上述指标不同程度反弹,但治疗组多数反弹指标仍优于对照组(,P,<0.05)。,结论,2,与常规药物治疗及生活干预相比,加用针刺治疗抗精神病药物相关代谢综合征疗效满意,并能辅助治疗精神疾病,且作用时间持久。
Objective,2,To observe the clinical efficacy of acupuncture combined with conventional therapy for antipsychotic drug-induced metabolic syndrome.,Methods,2,Ninety-three schizophrenia patients complicated with metabolic syndrome of qi deficiency and phlegm stagnancy syndrome were randomly divided into a control group (,n,=46) and a treatment group (,n,=47). The control group was administered with conventional medication and lifestyle interventions, while the treatment group was additionally administered with acupuncture treatment besides the treatment measures of the control group. The course of treatment for both groups was 3 months, and the patients were followed up constantly for 6 months after the end of treatment. Our research group also observed and compared the changes of the World Health Organization Quality of Life Assessment-BREF (WHO-QOL-BREF) score, the Global Assessment of Functioning (GAF) score, the Clinical Global Impressions scale (severity of illness and global improvement measures) (CGI-SI) score, Treatment Emergent Symptom Scale (TESS) score, waist circumference, hip circumference, body mass index, blood pressure and other general conditions, as well as the changes of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), fasting blood glucose (FPG), glycated hemoglobin (HbA1c) and other lab text indexes.,Results,2,①During the trial, there was one drop-out case in each group, and 91 cases finally completed the trial, including 46 cases in the treatment group and 45 cases in the control group. ②During the trial, there were no significant changes in WHO-QOL-BREF, GAF, CGI-SI and TESS scores, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, and related laboratory indexes in the control group (,P>,0.05). ③Patients in the treatment group showed higher GAF scores and WHO-QOL-BREF scores in physical domain and psychological domain (,P,<,0.05), lower CGI-SI and TESS scores (,P,<,0.05), and improved lipid-related laboratory indexes (,P,<,0.05) after 3 months. However, the above indexes rebounded to different degrees after 6 months, which were still better than those in the control group (,P,<,0.05).,Conclusion,2,Compared with conventional medication and life interventions, the additional treatment of acupuncture for antipsychotic drug-induced metabolic syndrome has more satisfactory efficacy and can assist the treatment of mental diseases with long-lasting effects.
代谢综合征抗精神病药物精神分裂症针刺
metabolic syndromeantipsychotic drugsschizophreniaacupuncture
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