维生素B_(12)与叶酸联合二甲双胍治疗2型糖尿病的疗效及其对同型半胱氨酸的影响

Curative Effect of Vitamin B_(12) and Folic Acid Combined with Metformin in the Treatment of Type 2 Diabetes Mellitus and the Effect on Homocysteine

目的研究维生素B12与叶酸联合二甲双胍治疗2型糖尿病的疗效及其对同型半胱氨酸的影响。方法选取我院2014年2月至2016年2月收治的150例2型糖尿病患者,随机分为三组。A组单独使用二甲双胍治疗,B组使用叶酸联合二甲双胍治疗,C组使用维生素B12与叶酸联合二甲双胍治疗。对比三组患者治疗前以及治疗后1个月、3个月、6个月的维生素B12水平、血清叶酸水平、同型半胱氨酸水平,观察三组患者治疗6个月内的并发症发生率。结果治疗前,三组患者的维生素B12水平、血清叶酸水平、同型半胱氨酸水平比较均无统计学差异(P>0.05)。治疗后,A组的维生素B12、血清叶酸水平显著下降(P<0.05),同型半胱氨酸水平显著提高(P<0.05);B组的维生素B12水平显著下降,血清叶酸、同型半胱氨酸水平无显著变化(P>0.05);C组的维生素B12、血清叶酸、同型半胱氨酸水平均无显著变化(P>0.05)。治疗后,C组的维生素B12水平高于A组和B组(P<0.05);B组和C组的叶酸水平均高于A组(P<0.05),同型半胱氨酸水平均低于A组(P<0.05)。A组的并发症发生率显著高于B组和C组(P<0.05);B组和C组的并发症发生率比较无统计学差异(P>0.05)。结论维生素B12与叶酸联合二甲双胍治疗2型糖尿病,能够控制患者的血糖水平,稳定维生素B12、叶酸、同型半胱氨酸水平,降低并发症发生率,值得临床推广。

Objective To study the curative effect of vitamin B,2 and folic acid combined with metformin in the treatment of type 2 diabetes mellitus and the effect on homocysteine. Methods 150 cases of patients with type 2 diabetes mellitus admitted to our hospital from February 2014 to February 2016 were selected and randomly divided into three groups. Group A only received metformin. Group B received folic acid and metformin. Group C received vitamin B12 and folic acid combined with metformin. The vitamin B^2, serum folic acid and homocysteine levels before treatment and 1 months, 3 months and 6 months after treatment after treatment were compared among three groups. The incidence of complications of three groups within 6 months was observed. Results Before treatment, no statistical difference was found in the vitamin B12, serum folic acid and homocysteine levels among three groups （P 〉0.05）. After treatment, the vitamin B,2 and serum folic acid levels of group A decreased significantly （P 〈0.05）, the homocysteine level increased significantly （P〈0.05）. The vitamin Bx2 level of group B significantly decreased, but the serum folic acid and homocysteine levels had no significant changes （P 〉0.05）. The vitamin B12, serum folic acid and homocysteine levels of group C had no significant changes （P〉0.05）. After treatment, the vitamin B12 level of group C was higher than those of group A and group B （P〈0.05）. The folic acid levels of group B and group C were higher than that of group A （P 〈0.05）, and the homocysteine levels were lower than that of group A （P 〈0.05）. The incidence of complications of group A was significantly higher than those of group B and group C （P 〈0.05）. No statistical difference was found in the incidence of complications between group B and group C （P 〉0.05）. Conclusions Vitamin B12 and folic acid combined with metformin in the treatment of type 2 diabetes mellitus can control blood sugar levels, maintain the vitamin B12, serum folic acid and homocysteine levels, and reduce the incidence of complications, which is worthy of clinical promotion.