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二甲双胍对伴发糖尿病的精神分裂症患者认知功能 的影响
王彩侠施小平朱闻孟召海江珉娅易正辉
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摘要:
目的 探讨二甲双胍对伴发糖尿病的精神分裂症患者认知功能的影响。方法 选择2016年 1 月—2017 年12 月在上海市金山区精神卫生中心住院的100 例伴发糖尿病的精神分裂症患者作为研 究对象,采用随机数字表法分为对照组和观察组各50 例。对照组给予非典型抗精神病药物+常规降血 糖药物+安慰剂治疗,观察组给予非典型抗精神病药物+常规降血糖药物+二甲双胍治疗。观察两组 治疗前后空腹血糖(FPG)、餐后2 h 血糖(2 hPG)、糖化血红蛋白(HbA1c)、重复性成套神经心理状态测验 (RBANS)评分,统计两组治疗过程中的不良反应。结果 两组治疗后FPG、2 hPG、HbA1c 水平与治疗前 相比较均显著降低(P<0.05),且观察组与同期对照组相比降低更明显(P<0.05)。两组治疗后即刻记忆、 视觉广度、言语功能、注意功能和RBANS 总分与治疗前相比均显著升高(P< 0.05),且观察组与同期对 照组相比升高更明显(P<0.05)。研究过程中两组均未见低血糖等严重不良反应,肝肾功能均未见异常, 安全性良好。结论 精神分裂症合并糖尿病的患者在常规治疗的基础上联合二甲双胍治疗可改善认知 功能,安全性良好。
关键词:  精神分裂症  糖尿病, 2 型  认知障碍  二甲双胍
DOI:10.3969/j.issn.1009-6574.2019.01.012
基金项目:上海市金山区科学技术创新资金项目(2017-3-23)
Effects of metformin on cognitive function in schizophrenia patients with diabetes
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Abstract:
Objective To investigate the effects of metformin on cognitive function in schizophrenic patients with diabetes. Methods A total of 100 schizophrenic patients with diabetes who were hospitalized in Jinshan Mental Health Center of Shanghai from January 2016 to December 2017 were selected as the study subjects. The patients were divided into control group and observation group with 50 cases in each group by random number table method. The control group was given atypical antipsychotic drugs as well as conventional hypoglycemic drugs and placebo, while the observation group was given atypical antipsychotic drug as well as conventional hypoglycemic drugs and metformin. The fasting blood glucose( FPG), postprandial 2 h sugar (2 hPG), glycosylated hemoglobin( HbA1c), and repetitive complete neuropsychological status test( RBANS) scores were observed before and after treatment in the two groups, and the adverse reactions in the two groups during the treatment were statistically analyzed. Results The levels of FPG, 2 hPG, and HbA1c in the two groups were significantly lower than those before the treatment( P<0.05). The decrease in the observation group was more obvious than that in the control group at the same time( P<0.05). The scores of immediate memory, visual span, speech function, attention function and RBANS in the two groups were significantly higher than those before treatment( P<0.05), and the increase in the observation group was more obvious than that in the control group at the same time. There were no serious adverse reactions such as hypoglycemia, abnormal liver and kidney functions, the safety of the two groups was good. Conclusions Patients with schizophrenia and diabetes mellitus treated with metformin on the basis of routine treatment can improve cognitive function, with good safety.
Key words:  Schizophrenia  Diabetes mellitus, type 2  Cognition disorders  Metformin

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