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肥胖的药物治疗

Pharmacotherapy for obesity.

作者信息

Joo Jong Kil, Lee Kyu Sup

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Pusan National University, Busan, Korea.

出版信息

J Menopausal Med. 2014 Dec;20(3):90-6. doi: 10.6118/jmm.2014.20.3.90. Epub 2014 Dec 24.

Abstract

Obesity is an important risk factor for metabolic disease and various cancers. Treatments of obesity include lifestyle intervention, pharmacotherapy, and bariatric surgery. If weight loss with lifestyle intervention is only modest, pharmacotherapy might be needed. Pharmacotherapy agents can be grouped by treatment period as short term or long term use agent. Several sympathomimetic drugs such as benzphetamine, diethylpropion, phendimetrazine and phentermine, are approved for short term treatment due to their safety issues. For long term treatment, orlistat, lorcaserin, and combination of phentermine/topiramate are approved by U.S. Food and Drug Administration (FDA). Orlistat partially blocks intestinal digestion of fat, therefore producing weight loss. Lorcaserin is a serotonin 2C receptor agonist. The combination of phentermine/topiramate produces a mean weight loss of 8-10 kg. Side effects of each drug are quite different. For obesity patient, side effects are important factor when choosing drugs. The goal of this article is to review currently available anti-obesity drugs.

摘要

肥胖是代谢性疾病和多种癌症的重要风险因素。肥胖的治疗方法包括生活方式干预、药物治疗和减肥手术。如果通过生活方式干预减肥效果不明显,可能就需要药物治疗。药物治疗药物可按治疗周期分为短期使用药物或长期使用药物。几种拟交感神经药物,如苄非他明、二乙丙胺苯丙酮、苯双甲吗啉和芬特明,由于存在安全问题,被批准用于短期治疗。对于长期治疗,美国食品药品监督管理局(FDA)批准了奥利司他、氯卡色林以及芬特明/托吡酯组合。奥利司他部分阻断肠道脂肪消化,从而实现减肥。氯卡色林是一种5-羟色胺2C受体激动剂。芬特明/托吡酯组合平均可减重8至10千克。每种药物的副作用差异很大。对于肥胖患者而言,副作用是选择药物时的重要考量因素。本文的目的是综述目前可用的抗肥胖药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16b2/4286660/e293e2a57e0a/jmm-20-90-g001.jpg

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