目的：探讨雷尼替丁预防精神分裂症患者服用奥氮平引起体质量增加及糖脂代谢障碍的临床效果。方法选择2014年4月至2015年2月广州市民政局精神病院收治的使用奥氮平治疗的100例精神分裂症患者，随机分为两组，各50例。两组抗精神病药均用奥氮平单药治疗，给予研究组雷尼替丁150 mg／d，晚睡前顿服，对照组晚睡前服用安慰剂（淀粉），分别检测血糖、血脂，并测量体质量指数、腰围、臀围，评估治疗前与治疗后不同时间PANSS量表及TESS量表结果。结果治疗后4周开始，研究组空腹血糖、总胆固醇及甘油三酯水平，体质量指数、腰围、臀围及PANSS量表及TESS量表评分均显著低于对照组（P＜0.05），研究组治疗过程中空腹血糖、总胆固醇及甘油三酯水平，体质量指数、腰围、臀围及PANSS量表及 TESS量表评分与入组时比较，差异无统计学意义（P＞0.05）。结论雷尼替丁可有效干预奥氮平治疗精神分裂症患者所致的体质量增加与血糖血脂调节障碍，且能显著提高治疗效果，减少不良反应。%Objective To investigate the prophylactic effects of ranitidine on increase in body mass and disorder of glucose and lipid metabolism caused by olanzapine in patients with schizophrenia.Methods 100 patients with schizophrenia treated with olanzapine from April of 2014 to February of 2015 in the Mental Hospital of Guangzhou Municipal Civil Affairs Bureau were ran-domly divided into two groups,50 cases in each group.The control group were treated with olanzapine and placebo (made with starch)while the study group were treated with olanzapine and ranitidine 150 mg/d.The levels of glucose,cholesterol were de-tected,and the body mass index,waist circumference,hip circumference was measured.The PANSS and TESS scale scores were assessed before treatment and after treatment.Results Four weeks after the start of treatment,the fasting plasma glucose,total cholesterol and triglyceride levels,body mass index,waist circumference,hip circumference and the PANSS and TESS scale scores in the study group were significantly lower than control group (P<0.05 ),and the fasting blood glucose,total cholesterol and triglyceride levels,body mass index,waist circumference,hip circumference and the PANSS and TESS scale scores in the study group had no significant difference with pretherapy (P>0.05 ).Conclusion Ranitidine can effectively intervent increase in body mass and disorder of glucose and lipid metabolism caused by olanzapine in patients with schizophrenia,significantly im-prove the therapeutic effect and reduce adverse reactions.
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