新型减重药物临床应用研究进展

Clinical Application and Research Progress of Novel Anti-Obesity Medications

摘要: 肥胖已成为全球性公共卫生问题，易诱发糖尿病、心脑血管疾病等多种并发症，严重威胁百姓身体健康。单纯依靠饮食管控与运动锻炼进行减重，患者长期依从性较差，整体干预效果有限，减重药物现已成为肥胖综合诊疗中重要的辅助治疗手段。当前临床常用减重药物主要分为脂肪酶抑制剂、GLP-1受体激动剂及中枢复方制剂三大类，主流用药包含奥利司他、利拉鲁肽、司美格鲁肽、贝那鲁肽、奥氟格列隆、替尔泊肽、玛仕度肽、瑞他鲁肽、纳曲酮/安非他酮、芬特明/托吡酯等。本文归纳各类减重药物的作用机理、临床疗效及安全特性，分析现阶段药物应用存在的实际问题，探讨减重药物研发方向与临床应用发展趋势，为临床科学选用减重药物、规范开展肥胖药物治疗提供参考依据。

Abstract: Obesity has evolved into a global public health crisis, as it predisposes individuals to multiple complications such as diabetes mellitus and cardiovascular and cerebrovascular diseases, thereby posing a severe threat to human health. Weight management relying solely on dietary restriction and physical exercise often suffers from poor long-term patient adherence and limited overall intervention efficacy. Consequently, anti-obesity medications have become an essential adjunctive therapy in the comprehensive diagnosis and treatment of obesity. Clinically prevalent anti-obesity drugs are primarily categorized into three classes: lipase inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and central nervous system combination preparations. The mainstream agents include orlistat, liraglutide, semaglutide, benaglutide, orforglipron, tirzepatide, mazdutide, retatrutide, naltrexone/bupropion, and phentermine/topiramate. This article systematically summarizes the mechanisms of action, clinical efficacy and safety profiles of each class of anti-obesity drugs, analyzes the practical challenges associated with their current clinical application, and discusses the research priorities and developmental trends of anti-obesity drugs. It aims to provide evidence-based references for rational medication selection and standardized pharmacotherapy for obesity in clinical practice.