拜糖平和美迪康对2型糖尿病降糖作用的临床疗效比较

A comparison of therapeutic efficacy of acarbose versus metformin in patients with type 2 diabetes mellitus

目的比较拜糖平和美迪康对２型糖尿病的临床疗效。方法将单纯饮食控制或加用磺脲类药物治疗不满意的２型糖尿病人８０例，随机分为拜糖平组４８例和美迪康组３２例，疗程为１６周。结果与结论美迪康对降空腹血糖的疗效率高于拜糖平（有效率分别为９６．９％：８５．７％，显效率为７１．９％：４７．６％；Ｐ均＜０．０１），而拜糖平对降餐后２小时血糖的疗效高于美迪康（有效率分别为９７．６％：９３．８％，显效率为７１．４％：６５．６％；Ｐ＜０．０１）；两药均能明显降低ＧＨｂＡ１ｃ，拜糖平组从９．１９％±２．７８％降至６．７６％±１．３３％（Ｐ＜０．０１），美迪康组从９．２３％±１．８９％降至７．１５％±１．２４％（Ｐ＜０．０１），两药相比对降低ＧＨｂＡ１ｃ的幅度无统计学意义（Ｐ＞０．５０）。两种药物不刺激胰岛素的分泌。

Objective Comparing the clinical effect between the acarbose and metformin in the treatment of type 2 diabetes mellitus. Methods Eighty patients with type 2 diabetes mellitus, who were poorly controlled on diet only or plus sulfonylureas treatment, were randomized into two groups and treated for 16 weeks with either acarbose 50～100mg tid (n=48) or metformin 250～500mg tid (n=32) separately. Results and Conclusion The results showed that both acarbose and metformin led to a reduction of GHbA 1c, the mean fasting and 2h postprandial blood glucose levels. The efficacy rate of reduction of the mean fasting blood glucose level with metformin was higher than that of acarbose (96.9% vs 85.7%; P<0.01), and the efficacy rate of reduction of the 2h postprandial blood glucose levels with acarbose was higher than that of metformin (97.6% vs 93.8%; P<0.01). The levels of GHbA 1c were reduced in both groups (P<0.01) but without statistically significant difference (P>0.50). The two drugs had no insulinotropic effect and did not affect the plasma lipid and the functions of liver and kidney.