阿卡波糖联合磷酸西格列汀治疗老年2型糖尿病疗效及对患者肠道菌群的影响

Acarbose in combination with sitagliptin phosphate for treatment of elderly patients with type 2 diabetes mellitus:Curative efficacy and effect on intestinal microflora

目的:探讨阿卡波糖联合磷酸西格列汀治疗老年2型糖尿病(type 2 diabetes mellitus,T2DM)疗效及对患者肠道菌群的影响.方法:100例符合纳入标准的老年新诊断T2DM患者随机分为对照组(n=50)和观察组(n=50).常规治疗基础上,对照组给予磷酸西格列汀治疗,观察组在对照组的基础上联合应用阿卡波糖治疗.观察比较两组患者血糖指标、血脂水平、肠道菌群及不良反应发生情况.结果:治疗后,与对照组相比,观察组血糖相关指标:空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2 hour plasma glucose,2 h PG)、糖化血红蛋白A1c(glycosylated hemoglobin,HbA1c)水平显著降低,血脂指标总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)水平显著降低,高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平显著升高,比较差异有统计学意义(均P<0.05).肠道菌群方面,与对照组相比,观察组治疗后G+b、G-b、c/b值明显升高,比较差异有统计学意义(均P<0.05),而G+c、G-c值两组间比较无统计学差异(均P>0.05).治疗过程中,均未出现低血糖不良反应.观察组和对照组不良反应发生率分别为16.0%和12.0%,组间比较差异无统计学意义(P>0.05).结论:阿卡波糖联合磷酸西格列汀是老年T2DM的有效治疗方案,能够显著改善血糖、血脂指标,调节肠道菌群,且不良反应轻微,临床上值得进一步研究.

AIM：To investigate the clinical efficacy of acarbose in combination with sitagliptin phosphate in the treatment of elderly patients with type 2 diabetes mellitus（T2DM） and the effect on intestinal microflora.METHODS：One hundred elderly patients with newly diagnosed T2 DM were randomly divided into two groups equally：a control group and an observation group.Besides conventional treatments,the control group was treated with sitagliptin phosphate,while the observation group was treated with acarbose combined with sitagliptin phosphate.Glucoserelated indices,levels of blood lipids,intestinal microflora-related indices including number of bacteria colonies and coccus/bacillus（c/b） value as well as the incidence of adverse reactions were compared for the two groups.RESULTS：In comparison with the control group after treatment,fasting plasma glucose（FPG）,2 h plasma glucose（2 h PG）,and glycosylated hemoglobin（HbAlc） were statistically lower in the observation group（P〈 0.05 for all）.As to blood lipids,the levels of total cholesterol（TC）,total glyceride（TG）,and low density lipoprotein cholesterol（LDL-C）were statistically lower and level of HDL-C was statistically higher in the observation group than in the control group after treatment（P 〈 0.05 for all）.Number of Gram-positive bacilli,Gram-negative bacilli and（c/b） value in the observation group were statistically higher than those in the control group after treatment（P 〈 0.05 for all）,while the number of Grampositive cocci and Gram-negative cocci in the two groups were statistically comparable（P 〉 0.05 for both）.During the treatment,no hypoglycemia occurred.The incidence of adverse reaction in the observation group was16.0%,which was statistically comparable to12.0%in the control group（P 〉 0.05）.CONCLUSION：Combined treatment of acarbose with sitagliptin phosphate is effective for elderly patients with T2 DM,which can significantly improve blood glucose,blood lipids and regulate intestinal microflora with minor adverse reactions.