莫沙必利联合黛力新治疗老年糖尿病合并功能性消化不良的疗效评价

Evaluation of the efficacy of mosapride combined with Delixin in the treatment of elderly diabetes mellitus complicated with functional dyspepsia

目的:探讨莫沙必利联合黛力新治疗老年糖尿病合并功能性消化不良(Functional dyspepsia,FD)患者的疗效及其对血糖代谢、胃肠动力的影响。方法:选取2020年1月至2022年1月本院收治的130例老年糖尿病合并FD患者为研究对象,采用奇偶数分组法分为单一组和联合组(n=65)。单一组口服黛力新(0.25 g·次^(-1)),联合组口服莫沙必利(5 mg·次^(-1))+黛力新治疗4 w观察临床疗效。同时于治疗前、后采用全自动糖化血红蛋白分析仪检测空腹血糖(Fasting plasma glucose,FPG)、空腹胰岛素(Fasting insulin,Fins)、胰岛素抵抗指数(Insulin resistance index,HOMA-IR)水平;采用CXE-2000型实时超声显像仪检测胃窦运动指数(Motilite index,MI)、收缩幅度(Shrinkage,△A/A)、收缩频率(Shrinkage frequency,F)、胃排空率;采用放射免疫分析法检测胃动素(Motilin,MTL)、胃泌素(Gastrin,GAS)、生长抑素(Somatostatin,SS)水平;采用放射免疫法检测一氧化氮(Nitric oxide,NO)、血管活性肠肽(Vasoactive intestinal peptide,VIP)水平;采用硝酸还原酶法检测P物质(Substance P,SP)水平。结果:联合组总有效率明显高于单一组(P<0.05);治疗后两组FPG、Fins、HOMA-IR低于治疗前,联合组FPG水平低于单一组(P<0.05);治疗后联合组MI、△A/A、F、胃排空率高于单一组(P<0.05);治疗后联合组MTL、GAS、NO、VIP水平低于单一组,SS、SP水平高于单一组(P<0.05);联合组不良反应发生率与单一组比较无明显差异(P>0.05),其复发率低于单一组(P<0.05)。结论:莫沙必利联合黛力新治疗老年糖尿病合并FD患者的疗效确切,可改善其血糖代谢、胃肠动力,纠正胃肠道功能紊乱,降低复发率,且具有一定安全性。

Objective:To investigate the efficacy of mosapride combined with Delixin in the treatment of elderly patients with diabetes mellitus and functional dyspepsia(FD)and its effects on blood glucose metabolism and gastrointestinal motility.Methods:From January 2020 to January 2022,130 elderly patients with diabetes mellitus with FD admitted to our hospital were selected as the research subjects,and they were divided into the single group and the combined group(n=65)by the odd and even grouping method.The patients in the single group were treated with Deanxit at the dose of 0.25 g,and the patients in the combined group were treated with Mosapride at the dose of 5 mg+Deanxit for 4 weeks.At the same time,the automatic glycated hemoglobin analyzer was used to detect fasting plasma glucose(FPG),fasting insulin(Fins),and insulin resistance index(HOMA-IR)levels before and after treatment.CXE-2000 real-time ultrasound imaging instrument was used to detect the gastric antral motility index(MI),shrinkage(△A/A),shrinkage frequency(F),and gastric emptying rate.Radioimmunoassay was used to detect the levels of motilin(MTL),gastrin(GAS),and somatostatin(SS).Radioimmunoassay was used to detect nitric oxide(NO)and vasoactive intestinal peptide(VIP)levels.The level of substance P(SP)was detected by the nitrate reductase method.Results:The total effective rate of the combined group was significantly higher than that of the single group(P<0.05),the FPG,Fins and HOMA-IR levels of the two groups after treatment were significantly decreased,and the FPG levels of the combined group were lower than that of the single group(P<0.05).The gastric emptying rates of MI,△A/A,F,and gastric in the combined group after treatment were higher than those in the single group(P<0.05),the levels of MTL,GAS,NO,and VIP in the combined group after treatment were lower than those in a single group,and the SS,The SP level was higher than that of a single group(P<0.05),and there was no significant difference in the incidence of adverse reactions in the combined group compared with that of a single group(P>0.05),and the recurrence rate was lower than that of a single group(P<0.05).Conclusion:The efficacy of mosapride combined with Delixin in the treatment of elderly patients with diabetes mellitus and FD is certain,it can improve their blood glucose metabolism,gastrointestinal motility,correct gastrointestinal dysfunction,reduce recurrence rate,and have a certain safety.