二甲双胍联合阿立哌唑改善抗精神病药致糖脂代谢异常微炎症状态的临床研究OA

Objective To evaluate the clinical efficacy and safety of metformin tablets combined with aripiprazole tablets in patients with glycemic and lipid metabolism abnormalities caused by antipsychotic medications.Methods Patients with mental disorders admitted to this hospital were divided into treatment group(metformin tablets,oral,starting dose 0.25 g,2-3 times daily,taken during or after meals,with the dose gradually increased based on efficacy,typically 1.0-1.5 g daily,in combination with aripiprazole tablets,taken orally,starting at 5 mg per day,with the dose gradually increased based on efficacy and tolerability)and control group(aripiprazole tablets alone,taken orally,starting at 5 mg per day,with the dose gradually increased based on efficacy and tolerability).Both groups received treatment for 8 weeks.The overall clinical response rate,positive and negative symptom scale(PANSS)scores,blood glucose,blood lipid levels and inflammatory markers were compared between the two groups,and safety was evaluated;logistic regression analysis was used to assess the independent effect of the treatment regimen on clinical efficacy;a binary log-binomial regression model was applied to calculate the relative risk of adverse drug reactions during treatment for patients in both groups.Results Using propensity score matching(PSM)for a 1∶1 match,a total of 240 patients were successfully matched,with 120 patients in each group.After 8 weeks of treatment,the overall clinical response rate in the control group was 70.83％(85 cases/120 cases),while that of treatment group was 90.00％(108 cases/120 cases),representing a statistically significant difference(P＜0.001).After 8 weeks of treatment,the PANSS total scores for treatment and control groups were(49.62±7.64)and(67.20±9.24)points,respectively;the fasting blood glucose(FBG)levels were(3.45±0.31)and(5.27±1.35)mmol·L-1,respectively;the triglyceride(TG)levels were(1.51±0.27)and(2.14±0.32)mmol·L-1,respectively;the interleukin-6(IL-6)levels were(12.57±3.01)and(15.99±4.25)pg·mL-1,respectively;the tumor necrosis factor-alpha(TNF-α)levels were(11.20±2.47)and(14.19±3.38)pg·mL-1,respectively.The above indicators in treatment group showed statistically significant differences compared to control group(all P＜0.05).The adverse drug reactions in both the treatment group and the control group were drowsiness,gastrointestinal irritation symptoms and liver dysfunction.The overall incidence of adverse drug reactions in treatment and control groups was 20.00％(24 cases/120 cases)and 15.83％(19 cases/120 cases),respectively,with no statistically significant difference(P＞0.05).Conclusion The combination of metformin tablets and aripiprazole tablets can significantly alleviate glucose and lipid metabolism abnormalities caused by antipsychotic medications in patients with mental disorders and improve their state of low-grade inflammation.