饮食疗法联合阿卡波糖对轻型糖尿病患者餐后血糖升高的治疗效果

The Effect of Diet Therapy Combined with Acarbose Treatment for Postprandial Blood Glucose Elevation of Patients with Mild Diabetes

目的探究饮食疗法联合阿卡波糖对轻型糖尿病患者餐后血糖升高的疗效。方法选取2013年7月至2015年8月来天津市宝坻区人民医院就诊的糖尿病患者132例,依据抽签法随机分为观察组和对照组,各66例。对照组给予患者口服阿卡波糖50 mg/次,每日1次,与餐同服进行治疗,观察组在对照组患者治疗方案的基础上依据患者体质量、血脂、血糖、营养状况等指标制定个体化饮食指导方案进行治疗。观察比较两组患者治疗前及治疗2周后的空腹血糖(FBG)、餐后2 h血糖(2h-PBG)、糖化血红蛋白(Hb A1c)、丙氨酸转氨酶(ALT)、血肌酐(Cr)、血尿素氮(BUN)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)等相关指标。结果治疗2周后观察组患者的FBG、2 h-PBG、ALT、Cr、BUN、TC、LDL-C、TG、药物维持剂量、血糖恢复时间[(5.9±0.5)mmol/L比(6.1±0.5)mmol/L,(7.2±0.6)mmol/L比(7.5±0.7)mmol/L,(43±8)U/L比(48±8)U/L,(98±14)μmo I/L比(105±17)μmo I/L,(6.9±0.9)mmol/L比(7.3±0.5)mmol/L,(4.68±0.67)mmol/L比(5.03±0.65)mmol/L,(2.54±0.65)mmol/L比(2.96±0.73)mmol/L,(1.35±0.41)mmol/L比(1.62±0.48)mmol/L,(69±14)mg/d比(77±19)mg/d,(6.8±1.5)d比(7.5±2.1)d,P<0.05]。观察组患者的HDL-C显著高于对照组[(1.56±0.47)mmol/L比(1.03±0.29)mmol/L,P<0.05];观察组患者治疗12周后的Hb A1c显著低于对照组[(5.36±1.17)%比(6.15±1.02)%,P<0.05];观察组患者的治疗总有效率显著高于对照组[98.48%(65/66)比89.39%(59/66),P<0.05]。治疗过程中观察组腹胀、腹痛、腹泻及低血糖发生率显著低于对照组[27.27%(18/66)比43.94%(29/66),10.61%(7/66)比24.24%(16/66),6.06%(4/66)比18.18%(12/66),1.52%(1/66)比10.61(7/66)],差异有统计学意义(P<0.05)。结论饮食疗法联合阿卡波糖可明显改善患者血糖水平,降低降糖药物维持剂量及药物不良反应的发生率,对血脂代谢同样具有一定的改善作用。

Objective To explore the effect of diet therapy combined with acarbose treatment for post- prandial blood glucose elevation of patients with mild diabetes. Methods From Jul. 2013 to Aug. 2015,132 patients with mild diabetes in Baodi District People＇s Hospital were included in the study and divided into an observation group and a control group according to draw method ,66 cases each. The control group was given aearbose 50 rag/time 1 time/clay orally, and the observation group was given individualized dietary guidance program according to the body mass, blood lipids ,.blood glucose, nutrition and other indicators of the patients, combined with acarbase for treatment. The fasting blood glucose （FBG）, 2-hour postprandial blood glucose （ 2 h-PBG ）, glycated hemoglobin （ HbAlc ）, alanine aminotransferase （ ALT）, serum creatinine （ Cr）, blood urea nitrogen （ BUN ）, total cholesterol （ TC ）, low density Iipoprotein cholesterol （ LDL-C ）, triglyccrides （TG） ,high density lipoprotein cholesterol （HDL-C） and other index were detected before and after 2 weeks of treatment. Results The FBG,2 h-PBG,ALT,serum Cr,BUN,TC,LDL-C,TG,drug maintenance dose, sugar recovery time of the observation group were significantly lower than the control group [ （ 5.9 ± 0. 5 ） mmol/L vs （6. 1 ± 0. 5 ） retool/L, （7.2 ± 0. 6 ） mmol/L vs （7.5 ± 0. 7 ） retool/L, （43 ± 8 ） U/L vs （48 ± 8 ） U/L, （98 ± 14 ） μmol/L vs （ 105 ± 17 ） μmol/L, （6. 9 ± 0.9 ） mmol/L vs （7.3 ± 0.5 ） minol/L, （4.68 ±0. 67） mmol/L vs （5.03 ±0. 65） retool/L, （2.54 ±0. 65） mmol/L vs （2.96 ±0. 73） mmol/L, （ 1.35 ± 0.41 ） mmol/L vs （ 1.62 ± 0. 48 ） mmol/L, （69 ± 14） mg/d vs （77 ± 19 ） mg/d, （6.8 ± 1.5 ） d vs （7.5 ± 2. 1 ） d, P 〈 0. 05 ]. The HDL-C of the observation group was significantly higher than the control group[ （1.56 ±0. 47） mmol/L vs （ 1.03 ±0. 29） mmol/L,P 〈0.05 ] ;the HbAlc of the observation group was significantly lower than the control group after 12 weeks of treatment [ （ 5.36 ± 1.17 ） % vs （ 6. 15 ± 1.02） % ,P 〈 0.051 ;the total effective of the observation group was significantly higher than the control group [ 98.48 % （65/66）vs 89.39% （59/66）, P 〈 0.05 ]. The incidence of abdominal distension, abdominal pain, diarrhea and hypoglycemia in the observation group were significantly lower than the control group [27.27% （18/66） vs43.94% （29/66）,10.61% （7/66） vs24.24% （16/66）,6.06% （4/55） vs 18. 18% （12/66） ,1.52% （1/66） vs 10. 61% （7/66） ] ,the differences were statistically significant（P 〈 0.05 ）. Conclusion Individualized diet combined with acarbose treatment can signifcantly improve blood sugar levels, reduce the incidence of adverse drug reactions and hypoglycemic drug maintenance dose,which can also improve lipid metabolism to a certain degree.