Clinical Study Of Personalized Drug Therapy For Schizophrenia Based On Gene Detection

Objective To study and compare the efficacy and safety of"drug treatment guided by drug gene detection"and"routine drug treatment based on doctors’experience",and the two methods were compared in extra pyramidal symptoms,body mass increase,glucose and lipid metabolism disorder and other adverse drug reactions.Methods A total of 98 patients enrolled in the 24 week randomized controlled clinical trial,2 patients were removed because of incomplete basic information,and 96 patients were assigned as experimental group and routine group randomly.The patients in the experimental group were treated by doctors with guided with the results of gene detection;The patients in the routine group were treated by doctors with routine drugs according to their experience.After the patients were successfully enrolled into the groups,we used the total score,score reduction rate,symptom improvement rate and treatment effectiveness rate of positive and negative symptom scale(PANSS)to evaluate the drug efficacy before treatment and at the end of 2,4,8,12,16,20 and 24weeks after treatment;Before treatment and 24 weeks after treatment,we measured patients’body weight and height,and we took the fasting venous blood of the patient that day,tested and recorded alanine aminotransferase,aspartate aminotransferase,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein and fasting blood glucose.All adverse drug events during the study were observed and recorded.Spss26.0 software was used for statistical test,and the counting data wereχ~2test,t test or rank sum test were used for measurement data,all statistical tests were bilateral tests,P<0.05 was statistically significant.Results(1)The total score of PANSS in the experimental group was significantly lower than that in the routine group.The score reduction rate,symptom improvement rate and treatment effectiveness rate in the experimental group were higher than those in the routine group(P<0.05).(2)There was no obvious difference in body mass,body mass index and glucose and lipid metabolism indicators between the two groups(P>0.05).The patients with increased body mass and disorder of glucose and lipid metabolism in the routine group were obviously more than those in the experimental group(P<0.05).(3)The metabolic phenotype of the experimental group was mainly extensive metabolic type;The metabolic phenotypes of CYP3A4 in the routine group were mainly extensive metabolic type(97.6%),the metabolic phenotypes of CYP1A2and CYP2D6 were mainly ultra rapid metabolic type(63.4%)and intermediate metabolic type(56.1%)respectively.There were significant differences in the distribution frequency of metabolic phenotypes on CYP1A2 and CYP2D6 between the two groups.Seven single nucleotide polymorphisms in DRD2,HTR1A,HTR2C and MCR4 genes were identified in this study.Single nucleotide polymorphisms were all consistent with the Hardy-Weinberg genetic equilibrium.There was significant difference in the distribution frequency of rs1799732 only in DRD2 gene between the two groups(P<0.05).Conclusions The results of this study show that"drug therapy guided by gene detection"is significantly better than"routine drug therapy relying on doctors’experience",and patients have fewer adverse reactions under the guidance of gene detection.The results of this study provide useful reference and evidence for drug gene detection to guide clinical medication.