阿卡波糖联合二甲双胍对2型糖尿病患者相关指标的影响

Effects of Acarbose Combined with Metformin on Related Indexes of Patients with Type 2 Diabetes

目的:探讨阿卡波糖联合二甲双胍对2型糖尿病患者相关指标的影响。方法:100例2型糖尿病患者随机分为对照组(50例)和观察组(50例)。对照组患者给予阿卡波糖片50 mg,口服,每日3次;观察组患者在对照组治疗的基础上给予盐酸二甲双胍片0.5 g,口服,每日3次。两组疗程均为12周。观察两组患者治疗前后空腹血糖(FPG)、空腹血浆胰岛素(FINS)、糖化血红蛋白(Hb A1c)、餐后2 h血糖(2 h PG)、餐后2 h胰岛素(2 h FINS)、胰岛素抵抗指数(HOMA-IR)、CD4^+T细胞中各Th细胞亚群比例、白细胞介素22(IL-22)、IL-17A、干扰素-γ(IFN-γ)水平及IL-22 m RNA、IL-17A m RNA、IFN-γm RNA表达水平,并记录不良反应发生情况。结果:治疗后,两组患者FPG、FINS、Hb A1c、2 h PG、2 h FINS、HOMA-IR、CD4^+T细胞中各Th细胞亚群比例、IL-22、IL-17A、IFN-γ水平及IL-22 m RNA、IL-17A m RNA、IFN-γm RNA表达水平均显著低于同组治疗前,差异均有统计学意义(P<0.05);两组间除CD4^+T细胞中Th1细胞亚群比例比较差异无统计学意义(P>0.05)外,其他指标均为观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿卡波糖联合二甲双胍可有效控制2型糖尿病患者的血糖,改善胰岛抵抗状态,平衡Th细胞亚群,降低炎性细胞因子水平,且未增加不良反应的发生。

OBJECTIVE： To investigate the effects of acarbose combined with metfonnin on related indexes of patients with type 2 diabetes mellitus. METHODS： A total of 100 patienls with type 2 diabetes mellitus were randomly divided into control group （50 cases） and observation group （50 cases）. Control group was given Acrbose tablet 50 mg orally, 3 times a day. Observa- lion group was additionally given Metformin hydrochloride tablet 0.5 g orally, 3 times a day, on the basis of control group. Both groups were treated for 12 weeks. The levels of fasting plasma glucose （FPG）, fasting plasma insulin （FINS）, glycosylated he- moglobin （HbA,c）, 2 11 postprandial plasma glucose （2 hPG）, postprandial 2 h insulin （2 hFINS）, insulin resistance index （HOMA-IR）, the proportion of Th cell subsets in CD,1~ T cells,lL-22,1L-17A and IFN-~,, mRNA expression of 1L-22,1L-17A and IFN-T were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS： After treatment, FPG, FINS, HbA1c, 2 hPG, 2 hFINS, HOMA-IR, the proportion of Th cell subsets in CD4^＋T cells, the concentrations of IL-22, IL-I 7A and IFN-7, expression of IL-22 mRNA, IL-17A mRNA and IFN-3, mRNA in 2 groups were significantly lower than before Ireatment, with statistical significance （P〈0.05） ; there was no significant difference in the proportion of Thl in T cells between 2 groups（P〉0.05）. Other indexes of observation group were signifcantly lower than those of control group, with statistical signifi- cance （P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： For patients with type 2 diabetes mellitus, acarbose combined with mefformin can effectively control the level of blood glucose, im- prove insulin resistance, balance Th cell subsets, reduce inflammatory factors levels but don＇t increase the occurrence of ADR.