阿卡波糖和伏格列波糖治疗2型糖尿病的比较

Efficacy and Safety of Acarbose and Voglibose in Treating Type 2 Diabetes Mellitus

目的 对两种α 糖苷酶抑制剂的疗效与安全性进行评价比较。方法 按 1997年ADA标准诊断的 2型糖尿病人 60例 ,按 1∶1分为阿卡波糖组和伏格列波糖组 ,经 2周筛选、8周治疗并比较。结果 与治疗前相比 ,阿卡波糖组和伏格列波糖组治疗 4周和 8周后 ,餐后 1h和 2h血糖均有明显下降 (P <0 .0 5 ) ,但空腹血糖下降不明显 (P >0 .0 5 )。阿卡波糖组在治疗 8周后 ,餐后 2h血糖下降较伏格列波糖组明显 (P <0 .0 5 )。两组HbA1c治疗后较治疗前明显降低 (P <0 .0 1) ,组间比较差异无显著性 (P >0 .0 5 )。伏格列波糖组治疗前后的空腹、餐后胰岛素水平无明显变化 (P >0 .0 5 )。阿卡波糖组治疗后空腹、餐后胰岛素均明显降低 (P <0 .0 1)。两组病人治疗前后血脂无显著变化 (P >0 .0 5 )。两组间治疗期间无低血糖、肝、肾功能损害发生 ,治疗之初常见胃肠道副作用 ,但可以耐受 ,组间比较差异无显著性。结论 阿卡波糖和伏格列波糖均为有效降低餐后血糖和HbA1c的药物 ,阿卡波糖与伏格列波糖对控制空腹血糖及餐后血糖疗效相同 ,阿卡波糖降低餐后 2h血糖和胰岛素水平较伏格列波糖明显。阿卡波糖和伏格列波糖均用药安全 。

Objective To evaluate the efficacy and safety of two kinds of Alpha glucosidase inhibitors in treating patients with type 2 diabetes mellitus.Methods 60 type 2 diabetic patients agreed the 1997 ADA diagnosis criteria were studied. The patients were assigned to either acarbose or voglibose treatment group in 1:1 ratio. The clinical trial lasted for 10 weeks, with 2 weeks for screening and 8 weeks for treatment with either acarbose or voglibose.Results After 4 and 8 weeks of treatment, postprandial 1 hour and 2 hour blood glucose (PBG1 and PBG2) were significantly lowered in two groups ( P <0.05). But fasting blood glucose (FBG) was not significantly lowered ( P >0.05). The reduction of PBG2 in acarbose group was more prominent than that in voglibose group ( P <0.05). HbA1c was significantly reduced in 2 groups after 8 weeks ( P <0.05). The difference in reduction of HbA1c between 2 groups was not significant. Fasting and postprandial insulin were significantly reduced in acarbose group ( P <0.01). But they were not significantly reduced in voglibose group ( P >0.05). As to total cholesterol, HDL Ch, and triglycerides in two groups, no significant changes were found. Gastrointestinal side effects were frequently reported in both two groups but no significant difference was found in between two groups. Hypoglycemia, liver and renal events were not reported.Conclusion Acarbose and voglibose significantly lower postprandial glucose and HbA1c levels. Postprandial insulin levels in acarbose group were more efficacious than that in voglibose group. They are safe and well tolerated in general.