胰岛素治疗2型糖尿病合并初治肺结核疗效观察

Curative Effect Observation of insulin therapy in type 2 diabetes mellitus complicated with newly-treated pulmonary tuberculosis

目的:观察胰岛素治疗2型糖尿病合并初治肺结核的疗效和安全性。方法:2型糖尿病合并初治肺结核患者60例,随机分为两组,各30例,治疗组予甘舒霖30R早晚餐前皮下注射,对照组予格列美脲+二甲双胍口服,观察12周,比较两组患者5个时点血糖、糖化血红蛋白、低血糖反应、痰菌阴转情况和肺结核病灶X线变化。结果:低血糖发生率两组无显著性差异(P>0.05),治疗组血糖和糖化血红蛋白显著低于对照组(P<0.05),痰菌阴转率治疗组(95%)显著高于对照组(72.2%)(P<0.05),病灶吸收情况治疗组(83.3%)显著好于对照组(53.3%)(P<0.01),空洞闭合治疗组(84.6%)显著好于对照组(54.5%)(P<0.01)。结论:胰岛素治疗2型糖尿病合并初治肺结核在控制血糖、痰菌阴转率、病灶吸收及空洞闭合情况均优于口服降糖药。

Objective：To observe the efficacy and safety of insulin therapy in type 2 diabetes mellitus complicated with newly-treated pulmonary tuberculosis. Methods：A total of 60 patients of type 2 diabetes mellitus complicated with newly-treated pulmonary tuberculosis were randomly divided into two groups,each 30;the treatment group was treated by Ganshulin 30R subcutaneous injection before breakfast and dinner, the control group treated by Glimepiri-de＋Metformin. The blood glucose for 5 times a day, HbA1c, hypoglycemia reaction, sputum conversion and tubercu-losis focus on chest X-ray were contrasted between the two groups after 12 weeks. Results：There was no significant difference on the rate of hypoglycemia reaction between the two groups （P＆gt;0.05）;but the level of blood glucose and HbA1c were significantly lower in the treatment group（P〈0.05）;the rate of sputum conversion was （95%） for the treat-ment group and （72.2%） for the control group, respectively, there was statistically significant difference between the two groups（P〈0.05）;the lung focus shrinking on chest X-ray was （83.3%） and that of the control group （53.3%） ,the treatment group was significantly better than the control group（P〈0.01）;the cavity closure was（84.6%） and that of the control group（54.5%） , the treatment group was significantly better than the control group（P〈0.01）. Conclusion：Pa-tients with type 2 diabetes mellitus complicated with newly-treated pulmonary tuberculosis treated by insulin were better than oral antidiabetic drugs in blood glucose control, the rate of sputum conversion, tuberculosis focus absorp-tion and cavity closure.