The Effect Of Olanzapine Combined With Probiotics In The Treatment Of Schizophrenia And The Correlation Analysis With Microbiota

BackgroundSchizophrenia is a chronic persistent disease with high recurrence rate and high disability rate.The intestinal flora of schizophrenic patients is often disturbed,which affects their immune metabolism and brain activity.At present,commonly used antipsychotic drugs,such as olanzapine and risperidone,can lead to abnormal blood lipid and glucose metabolism,high prolactin level and other side effects in clinical treatment,and can also affect the intestinal flora composition of schizophrenics,leading to constipation or diarrhea and other intestinal symptoms in some patients.From the perspective of probiotics combined with olanzapine,this study explored the effect of the combination of probiotics and olanzapine in patients with first-episode schizophrenia,as well as the changes of metabolic indicators and intestinal flora in patients after treatment.ObjectiveThis study compared the effects of conventional olanzapine treatment and combination of probiotics and olanzapine in the treatment of schizophrenia,and analyzed the differences of blood lipid,blood glucose and prolactin metabolism levels,combined with the abundance changes of intestinal specific functional flora,to clarify the effect of combined treatment of probiotics and olanzapine and the correlation with intestinal flora,providing new clinical basis for the application of probiotics in the treatment of schizophrenia.Methods1.The test data and some samples of schizophrenics treated in Zhumadian Second People’s Hospital from January 2018 to December 2019 were selected as the research objects,30 patients treated with olanzapine alone and olanzapine combined with probiotics(mainly bifidobacteria and lactobacilli)were selected,and the baseline data,blood samples and stool samples of the two groups of patients were collected.2.Schizophrenia severity scores were recorded in the positive and negative symptom scale scores of patients in the two groups before and after treatment,as well as the treatment effect comparison between the two groups.3.After treatment,the TC,triglyceride and LDL of the two groups were higher than those before treatment(P<0.05),while the level of HDL was lower than that before treatment(P<0.05);There was significant difference in the level of LDL between the two groups after treatment(P<0.05).4.Prolactin detection: The level of prolactin(PRL)in the blood of the two groups of patients was detected.5.Microflora analysis extracts genomic DNA of fecal microorganisms,and uses real-time fluorescent quantitative PCR method to detect the abundance changes of specific functional flora closely related to the occurrence and development of schizophrenia,including harmful bacteria,such as macrococcus,anoxic coccus,fecococcus,and beneficial bacteria,such as Rossiella,enterococcus,lactobacillus,bifidobacterium,and butyrate producing bacteria,which are considered to promote the occurrence of disease.Results1.Compared with before treatment,the positive symptom score,negative symptom score,general pathological symptom score and PANSS total score after olanzapine treatment and olanzapine plus probiotics treatment were reduced,with a statistically significant difference(P<0.05);All scores in the combined treatment group were lower than those in the olanzapine group alone,with a significant difference between the general pathological score and the total PANSS score(P<0.05),while the significant efficiency and ineffective rate were lower than those in the olanzapine group alone(P<0.05);The incidence of weight gain and total adverse reactions in the combined treatment group were lower than those in the olanzapine alone group(P<0.05).2.Compared with before treatment,the levels of glucose and lipid metabolism indicators(TCHO,TG,LDL,HDL,FPG)and PRL in the two groups after treatment were significantly changed;Compared with olanzapine alone,the LDL level of probiotics combined with olanzapine significantly decreased(P<0.05),and the prolactin level significantly increased(P<0.05).3.There was no significant difference between the two groups in intestinal flora before treatment(P>0.05).The abundance of macrococci,anaerobes and fecococcus decreased P<0.05),while the abundance of Rossiella,Enterococcus,Lactobacillus,Bifidobacterium and butyrate producing bacteria increased P<0.05 after treatment).In addition,there was a statistically significant difference between the two groups in the relative abundance of the above bacteria except anaerobes(P<0.05).4.The results of the correlation analysis between the therapeutic effect,metabolic indicators and specific functional flora showed that there was a positive correlation between the total score of PANSS and macrococcus(r=0.309),lactobacillus(r=0.339),bifidobacterium(r=0.425),anaerobes(r=-0.027),fecal cocci(r=-0.392),rosbacteria(r=-0.663)Enterococcus(r=-0.387)and butyrate producing bacteria(r=-0.505)were negatively correlated with the total score of PANSS(P<0.05);Macrococcus(r=0.309),Bifidobacterium(r=0.394)were positively correlated with PRL(P<0.05),Fecal coccus(r=-0.314),Rothia(r=-0.752),Enterococcus(r=-0.425)and butyrate producing bacteria(r=-0.442)were negatively correlated with PRL(P<0.05);Bifidobacterium was positively correlated with the LDL of the patients(r=0.298,P<0.05),and Rothia(r=-0.320),Enterococcus(r=-0.317)and butyrate producing bacteria(r=-0.336)were negatively correlated with the LDL of the patients(P<0.05).ConclusionsThis study found that probiotics combined with olanzapine can significantly improve the therapeutic effect on first-episode schizophrenia,reduce the incidence of glucose and lipid metabolism and prolactin secretion disorders,and its effect is related to improving the abundance of intestinal specific functional flora in patients,providing a new clinical basis for the application of probiotics in the treatment of schizophrenia.