基于评估的优化治疗模式对精神分裂症患者代谢综合征的影响(1)
[摘要] 目的 探討基于评估的优化治疗模式对精神分裂症患者代谢综合征(MS)的影响。 方法 选取2017年3月～2018年3月衡水市精神病医院诊治的120例精神分裂症患者，根据随机数字表法分为研究组和对照组，每组各60例。研究组服用利培酮片，疗效不佳者换用奥氮平治疗。对照组给予利培酮治疗。采用阴性及阳性症状量表(PANSS)评定精神病理学症状，不良反应症状量表(TESS)评估药物不良反应，记录并比较两组空腹血糖(FBG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)水平。 结果 两组治疗前阳性症状评分、阴性症状评分、一般精神病理评分、PANSS评分比较，差异无统计学意义(P > 0.05)。治疗第4周末两组阳性症状评分、阴性症状评分、一般精神病理评分、PANSS评分均低于治疗前，且研究组阳性症状评分、PANSS评分低于对照组，差异均有统计学意义(均P < 0.05)。治疗第8周末，两组阳性症状评分、阴性症状评分、一般精神病理评分、PANSS评分均低于治疗前及治疗第4周末，且研究组一般精神病理评分、PANSS评分显著低于对照组，差异均有统计学意义(均P < 0.05)。两组不同时间MS检出率比较，差异均无统计学意义(P > 0.05)。治疗前两组体重指数(BMI)、FBG、收缩压(SBP)、舒张压(DBP)、HDL-C水平比较，差异均无统计学意义(P > 0.05);研究组TG水平高于对照组，差异有统计学意义(P < 0.05)。治疗第4周末研究组FBG、SBP水平高于治疗前，对照组BMI、HDL-C水平高于治疗前;且研究组FBG、DBP水平高于对照组，差异均有统计学意义(均P < 0.05)。治疗第8周末研究组SBP水平低于治疗第4周末、TG水平高于治疗第4周末，FBG水平高于治疗前;对照组BMI、DBP水平高于治疗前;且研究组TG、HDL-C水平高于对照组，差异均有统计学意义(均P < 0.05)。与治疗第2周末比较，两组治疗第4周末、第8周末TESS评分均降低;与治疗第4周末比较，两组治疗第8周末TESS评分均降低，且研究组低于对照组，差异均有统计学意义(均P < 0.05)。 结论 基于评估的优化治疗模式治疗精神分裂症，其疗效优于传统治疗模式，对代谢综合征的治疗效果相似。
[关键词] 精神分裂症;评估;优化治疗;代谢综合征
[中图分类号] R749.3 [文献标识码] A [文章编号] 1673-7210(2020)03(b)-0092-05
[Abstract] Objective To explore the effect of evaluation-based optimal treatment on metabolic syndrome (MS) in schizophrenia. Methods From March 2017 to March 2018， 120 cases with schizophrenia who diagnosed and treated in Hengshui Mental Hospital were selected. According to the random number table method， they were divided into study group and control group， with 60 cases in each group. Study group was taking Risperidone Tablets， and those with poor curative effects switched to Olanzapine. Control group was given Risperidone Tablets. Psychopathological symptoms were assessed using the negative and positive symptom scale (PANSS)， and adverse drug reactions were assessed using the treatment emergent symptom scale (TESS). Fasting blood glucose (FBG)， triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) levels were recorded and compared between two groups. Results There was no significant difference in scores of positive symptoms， negative symptoms， general psychopathology and PANSS between two groups before treatment (P > 0.05). The scores of positive symptoms， negative symptoms， general psychopathology and PANSS at the end of the 4th week of treatment in two groups were lower than those before treatment， and the scores of positive symptoms and PANSS in study group were lower than those in control group， with statistically significant differences (all P < 0.05). The scores of positive symptoms， negative symptoms， general psychopathology and PANSS at the end of the 8th week of treatment in two groups were lower than those before treatment and the end of the 4th week of treatment， and the scores of general psychopathology and PANSS in study group were significantly lower than those in control group， with statistically significant differences (all P < 0.05). There was no significant difference in MS detection rate between two groups at different times (P > 0.05). There was no significant difference in body mass index (BMI)， FBG， systolic blood pressure (SBP)， diastolic pressure (DBP) and HDL-C between two groups before treatment (P > 0.05). TG level in study group was higher than that in control group， and the difference was statistically significant (P < 0.05). FBG and SBP levels at the end of the 4th week of treatment in study group were higher than before treatment， while BMI and HDL-C levels in control group were higher than before treatment， the levels of FBG and DBP in study group were higher than those in control group， with statistically significant differences (all P < 0.05). SBP level at the end of the 8th week of treatment in study group was lower than that at the end of the 4th week of treatment， TG level was higher than that at the 4th week of treatment， and FBG level was higher than that before treatment， BMI and DBP levels in control group were higher than those before treatment， TG and HDL-C levels in study group were higher than those in control group， with statistically significant differences (all P < 0.05). Compared with the 2th weekend of treatment， TESS scores in both groups were decreased at the 4th and 8th weeks of treatment; compared with the treatment group at the end of the 4th week， both groups had lower TESS scores at the end of the 8th week， and study group was lower than control group， with statistically significant differences (all P < 0.05). Conclusion The optimal treatment model based on evaluation is used to treat schizophrenia， which has better efficacy than traditional treatment model and has similar effects on metabolic syndrome., 百拇医药(郗玲燕 金圭星 乔静爽)
[关键词] 精神分裂症;评估;优化治疗;代谢综合征
[中图分类号] R749.3 [文献标识码] A [文章编号] 1673-7210(2020)03(b)-0092-05
[Abstract] Objective To explore the effect of evaluation-based optimal treatment on metabolic syndrome (MS) in schizophrenia. Methods From March 2017 to March 2018， 120 cases with schizophrenia who diagnosed and treated in Hengshui Mental Hospital were selected. According to the random number table method， they were divided into study group and control group， with 60 cases in each group. Study group was taking Risperidone Tablets， and those with poor curative effects switched to Olanzapine. Control group was given Risperidone Tablets. Psychopathological symptoms were assessed using the negative and positive symptom scale (PANSS)， and adverse drug reactions were assessed using the treatment emergent symptom scale (TESS). Fasting blood glucose (FBG)， triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) levels were recorded and compared between two groups. Results There was no significant difference in scores of positive symptoms， negative symptoms， general psychopathology and PANSS between two groups before treatment (P > 0.05). The scores of positive symptoms， negative symptoms， general psychopathology and PANSS at the end of the 4th week of treatment in two groups were lower than those before treatment， and the scores of positive symptoms and PANSS in study group were lower than those in control group， with statistically significant differences (all P < 0.05). The scores of positive symptoms， negative symptoms， general psychopathology and PANSS at the end of the 8th week of treatment in two groups were lower than those before treatment and the end of the 4th week of treatment， and the scores of general psychopathology and PANSS in study group were significantly lower than those in control group， with statistically significant differences (all P < 0.05). There was no significant difference in MS detection rate between two groups at different times (P > 0.05). There was no significant difference in body mass index (BMI)， FBG， systolic blood pressure (SBP)， diastolic pressure (DBP) and HDL-C between two groups before treatment (P > 0.05). TG level in study group was higher than that in control group， and the difference was statistically significant (P < 0.05). FBG and SBP levels at the end of the 4th week of treatment in study group were higher than before treatment， while BMI and HDL-C levels in control group were higher than before treatment， the levels of FBG and DBP in study group were higher than those in control group， with statistically significant differences (all P < 0.05). SBP level at the end of the 8th week of treatment in study group was lower than that at the end of the 4th week of treatment， TG level was higher than that at the 4th week of treatment， and FBG level was higher than that before treatment， BMI and DBP levels in control group were higher than those before treatment， TG and HDL-C levels in study group were higher than those in control group， with statistically significant differences (all P < 0.05). Compared with the 2th weekend of treatment， TESS scores in both groups were decreased at the 4th and 8th weeks of treatment; compared with the treatment group at the end of the 4th week， both groups had lower TESS scores at the end of the 8th week， and study group was lower than control group， with statistically significant differences (all P < 0.05). Conclusion The optimal treatment model based on evaluation is used to treat schizophrenia， which has better efficacy than traditional treatment model and has similar effects on metabolic syndrome., 百拇医药(郗玲燕 金圭星 乔静爽)
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