二甲双胍的临床应用及研究进展

Clinical applications and research progresses of metformin

二甲双胍(Metformin)是目前临床上使用最广泛的一种口服降糖药物,与其他口服降糖药物相比,其降糖效果肯定,低血糖发生风险小,价格适中,因而被国内外各大指南推荐为一线降糖药物。二甲双胍主要通过抑制肝糖原异生,减少肝糖输出,增加机体对胰岛素的敏感性,抑制肠道吸收葡萄糖而降低血糖;此外,二甲双胍还有延缓2型糖尿病的发生、调节血脂、减轻体重、保护心血管的作用;还可用于治疗多囊卵巢综合征合并糖耐量降低的2型糖尿病患者、有明显肝损害的非酒精性脂肪肝的患者,同时具有抗肿瘤作用。安全性方面,二甲双胍最常见的不良反应是消化道反应,最严重的不良反应是乳酸酸中毒,但罕有发生。

Currently, metformin is most widely used in clinic as an oral antidiabetic drug. Compared with other oral antidiabetic drugs, metformin is effective in reducing blood glucose absolutely. The risk of hypoglycemia is low. The price is moderate. Metformin is recommended as a first-line antidiabetic drug in domestic and international guidelines. Metformin mainly acts by inhibiting hepatic gluconeogenesis,reducing glycogen output, increasing the body＇s sensitivity to insulin and inhibiting the intestinal absorption of glucose to reduce blood glucose. In addition,metformin can delay the development of type2 diabetes,regulate blood lipid,reduce body weight,protect cardiovascular,which also can be used to treat patients who suffer from polycystic ovary syndrome with impaired glucose tolerance of type 2 diabetes,nonalcoholic fatty liver with obvious liver damage and malignant tumor. In safety,the most common adverse effect of metformin was gastrointestinal reactions,and the most severe adverse effect was lactic acidosis,but rarely appeared.