中低強度運動對服用第二代抗精神藥物Clozapine的肥胖精神分裂症病患之影響

代謝症候群是服用第二代抗精神藥物的嚴重副作用，但是現在仍無有效的體重控制策略，本研究要探討12週中低強度踏步機有氧運動介入對服用Clozapine之肥胖慢性精神分裂症病患身體組成、血脂肪、精神症狀與憂鬱程度的相關影響。研究採立意選取診斷爲精神分裂症、年齡小於60歲且身體質量指數大於24kg/平方公尺之病患，依個案意願分爲對照組與運動組。結果顯示受試者中男性對身材滿意度高於女性，且符合代謝症候群診斷及憂鬱比率高於一般族群(57.14%)。運動組與對照組相比能更有效的控制體重、身體質量指數、腰圍、體脂肪，並能改善憂鬱及部分精神症狀(P≤0.05)，反之對血液生化數值並無顯著影響。在相關性分析中發現運動時間、踏步次數、正餐次數前後測差、零食次數前後測差與腰臀比、血脂肪前後測差呈中度相關。建議未來研究可增加樣本的多樣性、使用隨機分組，排除糖尿病、高血脂之個案以避免研究的誤差，並延長運動及後續追蹤時間以加強效果。

關鍵字

代謝症候群；第二代抗精神藥物；身體質量指數

並列摘要

Metabolic syndrome is a notable side effect of numerous atypical antipsychotic medications, yet successful strategies for achieving significant weight loss are lacking. This study assesses the effects of 12 weeks of stepper training on body composition, blood lipid profile, psychotic symptoms and depression in schizophrenic patients treated with clozapine. Thirty-three schizophrenic patients (Body Mass Index, BMI＞24 Kg/m^2, age＜60 yrs) were divided into exercise and control groups. Pre-test data indicated that male patients had higher satisfaction with their figure than did females; moreover the prevalence of metabolic syndrome and depression disorder were higher among the study group than the common population (57.14%). Compared with the control group, the exercise group displayed improved body weight, BMI, waist circumference, body fat, depression and psychiatric symptoms. However the blood biochemical laboratory data did not differ significantly following training. The exercise duration exhibited a moderate negative correlation with change in Waist-Hip-Ratio, and moderately and positively correlated with high density lipoprotein change. Furthermore, a moderate positive correlation existed between change in daily snack times and change in low density lipoprotein (P＜0.05). Regarding future research directions, we recommend increasing the sample diversity, conducting random grouping, and excluding patients with diabetes mellitus or history of hyperlipidemia to reduce the study bias. Additionally, this investigation also recommends extending the exercise duration and follow-up period to obtain more definite results.