双相胰岛素注射剂联合阿卡波糖治疗2型糖尿病36例

Effect of Biphasic Insulin Injection and Acarbose Therapeutic Alliance on 36 Cases of Type 2 Diabetes Mellitus

目的比较双相胰岛素注射剂(诺和灵30R)单用和联合阿卡波糖治疗2型糖尿病的疗效。方法2型糖尿病患者78例分为两组。对照组42例,给予双相胰岛素注射剂治疗,早晚餐前皮下注射,剂量初为0.4U.kg-1.d-1,3 d后复查血糖并调整胰岛素用量,直至血糖控制理想或良好,疗程4周。治疗组36例,在对照组的治疗方案上加用阿卡波糖150 mg.d-1,疗程4周。观察两组治疗前后的空腹血糖、早餐后2 h血糖、空腹血胰岛素(F-Ins)、餐后2 h血胰岛素(P-Ins)、空腹血C肽(F-CP)、餐后2 h血C肽(P-CP)、血糖化血红蛋白(HbA1 c)、血清三酰甘油(TG)、血清总胆固醇(TC)及体重指数(MB I)。结果治疗组治疗后除MB I外上述各项指标与治疗前均显著改善(P<0.01或P<0.05);治疗后早餐后2 h血糖、HbA1 c、TG及P-Ins改善均比对照组显著,差异有极显著性或显著性(P<0.01或P<0.05)。结论双相胰岛素注射剂联合阿卡波糖,通过两者协同互补作用,有效降低血糖,减少胰岛素用量。

Objective To compare the effects between biphasic insulin injection （Novolin 30R ） alone and its therapeutic alliance with acarbose on type 2 diabetes mellitus （T2DM）, Method Seventy-eight cases of diabetic mellitus patients were randomly divided into two groups, The control group （n = 42）was given biphasic insulin injection alone, the initial dose was 0.4 U·kg^-1·d^-1. The dose of biphasic insulin injection was adjusted to control the serum glucose at a satisfied level by monitoring the serum glucose every three days. The treatment group （n = 36） was given biphasic insulin injection and acarbose （150 mg·d^-1）. The treatment course of both lasted 4 weeks. The fasting serum glucose, postprandial serum glucose, fasting serum insulin（ F-Ins）, postprandial serum insulin（ P-Ins）, fasting serum C peptide（ F-CP）, postprandial serum C peptide （P-CP）, HbA1c, triglycerode（TG）, total cholesterol （TC） and body weight index（MBI） were measured before and after treatment. Results F-Ins, P-Ins, F-CP, P-CP, HbAlc, TG, TC of the treatment group except MBI were significantly improved after treatment （ P 〈 0.05 or P 〈 0.01 ）. The postprandial serum glucose, HbA1 c, TG, TC, and P-Ins were improved significantly or very significantly between the control and treatment groups after treatment （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Biphasic insulin injection combined with acarbose lowers the serum glucose effectively and reduces the dosage of insulin.