近日节律法在社区2型糖尿病口服降糖药物治疗中的应用效果

The Application Effect of Recent Rhythm Method in the Treatment of Community Type 2 Diabetes by Oral Hypoglycemic Drugs

目的探讨近日节律法口服降糖药物干预2型糖尿病（T2DM）患者的临床效果及安全性。方法选取2013年4～7月东莞市沙田医院收治的120例社区他DM患者为研究对象，依据随机数字表法分为对照组和观察组，各60例。对照组给予常规二甲双胍0．5g三餐前口服治疗，观察组给予血糖监测，找到每例患者特有的血糖近日节律规则，制订个性化定时药物治疗。比较两组患者治疗3个月后的降糖效果、不良反应及心脑血管事件发生率。结果治疗后观察组血糖峰值、空腹血糖、糖化血红蛋白均显著低于对照组[（10±3）mmol／L比（12±3）mm61／L、（5．9±1．8）mmol／L比（6．4±2．1）mmol／L、（6．3±1．2）％比（7．0±1．3）％]（P〈0．01）。观察组低血糖发生率为8．3％，低于对照组的23．3％，心脑血管不良事件发生率为8．3％，低于对照组的20．0％，差异有统计学意义（P〈0．01）。结论近日节律法给予社区T2DM患者个性化的时间生物性降糖药物治疗，能降低血糖高峰、回避血糖低谷，有效降低患者不良反应及心脑血管事件发生率。

Objective To discuss the clinical effect and safety of recent rhythm method for the treatment of type 2 diabetes mellitus （T2DM） by oral hypoglycemic drug. Methods From Donggnan Shatin Hospital during April and July 2013,120 T2DM cases were included, the patients were randomly divided into observa- tion group and control group according to random number table method ,60 cases in each group. The control group received conventional mefformin 0.5 g, orally before three meals ,the observation group was given blood glucose monitoring, and the recent blood glucose rhythm rules of each patient was found out, and individual- ized medication timing was made. The hypoglycemic effect, the adverse reactions and cardiovascular event rate of the two groups were compared three months later. Results After treatment blood glucose peak, fasting blood glucose, glyeosylated hemoglobin of the observation group were significantly lower than the control group [ （ 10 ±3 ） mmol/L vs （ 12 ± 3 ） mmol/L, （ 5.9 ± 1.8 ） mmol/L vs （ 6.4 ± 2.1 ） mmol/L, （ 6.3 ± 1.2 ） % vs （7.0 ± 1.3 ） % ] （ P 〈 0.01 ）, The hypoglycemia of the observation group was 8.3 %, lower than the 23.3% of the control group, the incidence of cardiovascular and cerebrovascular adverse events was 8.3% ,lower than the 20.0% of the control group ,the differences were statistically significant（ P 〈 0.01 ）. Conclusion Recent ：rhythm method to assist make the hypoglycemic medication timing plan for T2DM patients can reduce blood sugar peaks, avoid sugar trough, thus effectively reduce the incidence of adverse reactions and cardiovascular events.