雌激素替代治疗对2型糖尿病围绝经期妇女血糖的影响

Effect of menopausal hormone therapy on blood glucose in perimenopausal women with type 2 diabetes

目的:分析激素替代治疗对2型糖尿病围绝经期妇女血糖的影响。方法:随机选取2014年6月至2016年6月于石家庄市第二医院就诊的2型糖尿病围绝经期患者82例,随机分为观察组(n=41)与对照组(n=41),两组均给予降血糖等常规治疗,观察组给予替勃龙治疗,对照组给予复合维生素B进行安慰剂治疗,对比两组患者的临床疗效、血糖水平、胰岛素抵抗相关指标水平。结果:观察组治疗总有效率为97.56%,对照组为80.48%,两组疗效比较差异有统计学意义(χ~2=6.116,P=0.013);治疗前E2,FPG,2h PG,HbAlc,HOMA-IR,resistin,TNF-α和CRP等水平两组比较,差异无统计学意义(P>0.05);治疗后观察组FPG,2h PG,HbAlc,HOMA-IR,resistin,TNF-α和CRP水平明显下降,与治疗前比较,差异有统计学意义(P<0.05);E2水平有所升高,但与治疗前比较,差异无统计学意义(P>0.05);对照组治疗后上述指标变化不明显,与观察组治疗后相关指标比较,差异有统计学意义(P<0.05)。结论:采用替勃龙治疗2型糖尿病围绝经期患者,能够显著降低患者的血糖水平,治疗效果良好。

Objective： To observe and analyze the influence of hormone replacement therapy on blood glucose of perimenopausal women with type 2 diabetes. Methods： Eighty-two perimenopausal patients with type 2 diabetes hospitalized in Second Hospital of Shijiazhuang during June 2014 to June 2016 were selected and randomly divided into an observation group （n=41） and a control group （n=41）. Based on conventional hyperglycemic treatment, we applied Livial to the observation group while complex vitamin B for placebo treatment to the control group, and compared the clinical effect, blood glucose level, insulin resistance and relevant indexes. Results： The total effective rates of the observation group and the control group were 97.56% and 80.48% respectively, and the difference was statistically significant （X^2=6.116, P=O.O13）; the difference ofpre-treatment levels of E2, FPG, 2hPG, HbAlc, HOMA-IRj resistin, TNF-a and CRP between two groups was not statistically significant （P〉0.05）; the post-treatment levels ofFPG, 2hPG, HbAlc, HOMA-IR, resistin, TNF-α and CRP in the observation group decreased obviousl）5 and compared with those before treatment, the difference was statistically significant （P〈0.05）; estrogen level increased slightly, but compared with that before treatment, the difference was not statistically significant （P〉0.05）; the variation of above indexes after treatment in the control group was not obvious, but compared with relevant indexes in the observation group after treatment, the difference was statistically significant （P〈0.05）. Conclusion： Adopting tibolone to treat perimenopausal type 2 diabetes patients can obviously reduce blood glucose with better therapeutic effect.