赛庚啶对2型糖尿病糖代谢的影响

Effecf of cyproheptadine on blood glucose metabolism in type 2 diabetes mellitus

目的探讨赛庚啶对2型糖尿病糖代谢的影响及其机理。方法随机选择2型糖尿病49例，在标准饮食的基础上分别服用赛庚啶、赛庚啶加美吡达及单独服美吡达，自身比较不同处治方案前后血糖、血胰岛素、C-肽、皮质醇及生长激素的差异。结果①服用赛庚啶后，餐后2h血糖（2hBG）比服药前平均下降203mmol／L（P＜0．05）；②服用美吡达后，2hBG比服药前下降3.3mmol／L（P＜0．001）；③美吡达合用赛庚啶后2hBG比服药前下降6．17mmol／L（P＜0．001），同时相血皮质醇及生长激素亦有明显下降（P＜0．001）。结论赛庚啶通过抑制生长激素及皮质醇分泌，减少其对胰岛素的拮抗作用，间连降低血糖，与美吡达合用具有快同降糖作用，疗效高于单用美吡达（血糖下降率为33．5％比17．9％，P＜0．001)。

Objective Studing the effect and mechanism of Cyproheptadine on blood glucose metabelism in type 2 diabetes mellitus. Mithods Random selection of forty-nine patients with type 2 diabetes mellitus was made. Befor and after administering Cyproheptadine, Cyproheptadine with Meibida and Meibida only for 4 to 5 days, blood sample was separately took to ascertain blood glucose (BG)、Insulin (Ins)、C-Petide(C-P)、 cortisol(F) and growth hormone (GH) on the basic standard diet and comparing the clinical effect of the different treatment. Results 1. The mean concentration of 2h postprandial blood glucose (2hBG) after Cyproheptadine was decreased 2. 03mmol/L, (P <0 .05). 2. The mean concentration of 2hBG after Meibida decreased 3. 3mmol/L, (P<0.001). The mean concentration of 2hBG after Cyroheptadine with Meibida was decreased 6. 17mmol/L(P < 0.001 ), and the concentrations of blood cortisol and growth hormone were dramatically reduced (P<0.001) at the same time.Conclusion Cyproheptadine can indireatly decrease BG by inhibiting the secreations fo GH and F, and the efficacy rate of reduction of 2hBG of administering Cyproheptadine with Meibida is higher than that of Meibita merely (33. 51 % vs 17. 93%, P<0.001).