n-3多元不飽和脂肪酸對日間留院精神分裂症病患之輔助治療效應

Prosthetic treatment of n-3 polyunsaturated fatty acid to day care schizophrenic patients

吳采璇(Sia-Shan Wu)

指導教授 ： 黃士懿

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2003年)

摘要

本研究旨在探討n-3多元不飽和脂肪酸對精神分裂症病患症狀改善及副作用之輔助治療效果。本實驗募集20位日間留院長期藥物治療之精神分裂症病患，並且募集性別、年齡及身高相仿的20位健康人作為控制組，進行飲食、體位、血液生化值及脂肪酸分析比較。另一實驗，隨機將病患分成二組，魚油組給予每天4.4 g EPA及2.2 g DHA；安慰劑組給予等劑量之油酸，於介入前(第0週)及後(第2、4、8、12週)進行血液脂肪酸及正性及負性症狀評量(PANSS)分析。結果顯示，病患BMI顯著高於控制組(p<0.05)；紅血球AA (%)顯著低於控制組(p<0.05)，EPA及DHA (%)比控制組有較低的趨勢。魚油組於實驗期第二週，病患BMI有下降的趨勢；補充期間，紅血球AA (%)有顯著的增加(p<0.05)，DHA (%)亦有增加的趨勢，於第12週時顯著高於安慰劑組(p<0.05)，精神症狀亦有改善的現象，但並無呈顯著差異。由相關係數分析發現，魚油組紅血球AA及DHA (%)與症狀嚴重度(PANSS)呈顯著負相關性(p<0.05)，特別在第8週及第12週。綜合以上結果，紅血球AA及DHA (%)可能可當作精神分裂症生理病理及診斷的參考標記之一；本實驗魚油組與安慰劑組比較並未呈現顯著的輔助治療效果，推測可能原因包括病患病史，抗精神病劑以及飲食等因子干擾所致。

關鍵字

n-3多元不飽和脂肪酸 ； 體組成 ； 精神分裂症

並列摘要

The aim of study is to investigate the prosthetic effect of n-3 polyunsaturated fatty acid on symptoms improvement and drug -induced side effects in patients with schizophrenia. The dietary assessment, body composition, laboratory characteristics and blood fatty acids analysis in mediated day care schizophrenic patients (n=20) were measured and compared with a health control group (n=20). In the randomized double-blind placebo-controlled study, blood fatty acids and Positive and Negative Syndrome Scale (PANSS) were measured from fish-oil group received 4.4 g EPA and 2.2 g DHA per day and placebo group received 6.6 g 90% n-9 fatty acid per day during the 12-week supplementation. The result showed that BMI of patients was significant higher and erythrocytic arachidonic acid (AA) was significant lower than control subjects (p<0.05). A lower tendency in both EPA and DHA (%) of erythrocyte in schizophrenic patients. After the 2-week supplementation, a lower tendency in BMI of patients in fish-oil group. Erythrocytic AA (%) in fish-oil group were increased significantly during the supplementation (p<0.05) and erythrocytic DHA (%) in fish-oil group were higher than placebo group after the 12-week supplementation (p<0.05). PANSS of patients were improved slightly during the study period. Furthermore, an negative correlation between erythrocytic AA and DHA (%), and PANSS in fish-oil group (p<0.05), not in placebo group. We concluded that erythrocytic membrane AA and DHA (%) could be one of reliable biomarker for physiopathology and diagnostics of patients with schizophrenia. However, it’s hard to find the prosthetic effect of n-3 fatty acid-rich fish oil in chronic schizophrenic patients with antipsychotic agents, the confounding factor such as history, medication, diet factor etc., is needed to be considered.

並列關鍵字

n-3 polyunsaturated fatty acid ； body composition ； schizophrenia

參考文獻

Csernansky JG, Whiteford HA (1987) Clinically significant psychoactive drug interactions. In Hales RE and Frances AJ, eds.: Psychiatry Update: American Psychiatric Association Annual Review. Vol. 6. Washington, DC American Psychiatric Press. Delion S, Chalon S, Guilloteau D, Besnard JC, Durand G (1996) Alpha- linolenic acid deficiency alters age-related changes of dopaminergic and serotonergic neurotransmission in the rat frontal cortex. J Neurochem 66: 1582-1591.

英文部份 Amdisen A (1964) Drug-produced obesity: experiences with chlorpromazine , perphenazine, and clopenthixol. Dan Med Bul 11: 182-189.

Arvindakshan M, Sitasawad S, Debsikdar V, Ghate M, Evans D, Horrobin DF, Bennett C, Ranjekar PK, Mahadik SP (2003) Essential polyunsaturated fatty acid and lipid peroxide levels in never-medicated and medicated schizophrenia patients. Biol Psychiatry 53: 56-64.

Auwerx J, Staels B (1998) Leptin. Lancet 351: 737-742.

Baptista T, Lacruz A, Meza T, Contreras Q, Delgado C, Mejias MA, Hernandez L (2001) Antipsychotic drugs and obesity: Is prolactin involved? Can J Psychiatry 46: 829-834.