阿卡波糖联合二甲双胍治疗2型糖尿病并发周围神经病变的临床效果

Clinical effect of acarbose combined with metformin on type 2 diabetes mellitus complicated with peripheral neuropathy

目的探讨阿卡波糖联合二甲双胍治疗2型糖尿病并发周围神经病变的临床效果。方法选择2020年1月至2021年8月收治的2型糖尿病合并周围神经病变患者80例为研究对象。按照随机数字表分为对照组和观察组,各40例。针对周围神经病变使用甲钴胺、依帕司他,针对血糖控制上,对照组使用阿卡波糖,观察组则联合应用二甲双胍,比较两组治疗前后血糖控制相关指标、外周神经功能缺陷评分变化及外周神经运动觉传导速度,统计两组治疗期间发生的不良反应。结果治疗后,观察组糖化血红蛋白、空腹血糖及餐后2小时血糖水平均显著低于治疗前和治疗后对照组(P<0.001),外周神经功能缺陷评分指标中大拇指振动觉、针刺觉、温度觉评分均明显低于治疗前和治疗后对照组(P<0.001),外周神经中正中神经、腓神经运动觉传导速度显著大于治疗前和治疗后对照组(P<0.05),两组发生恶心呕吐、大便不成形、低血糖、头晕的总比例比较差异无统计学意义(P>0.05)。结论针对2型糖尿病周围神经病变者在使用阿卡波糖的基础上联合二甲双胍治疗,能更好地控制血糖,改善周围神经功能,且不良反应少,安全性高。

Objective To explore the clinical effect of acarbose combined with metformin in the treatment of type 2 diabetes mellitus complicated with peripheral neuropathy.Methods 80 patients with type 2 diabetes mellitus complicated with peripheral neuropathy admitted to hospital from January 2020 to August 2021 were selected as research objects.They were divided into control group and observation group according to random number table,with 40 cases in each group.Mecobalamin and epalrestat were used for peripheral neuropathy.For blood glucose control,acarbose was used in the control group and metformin was used in the observation group.And then,the related indexes of blood glucose control,the changes of peripheral nerve function defect scores and the motor sensory conduction velocity of peripheral nerves were compared between the two groups before and after treatment,and the adverse reactions during the treatment were counted.Results After treatment,the glycated hemoglobin level,fasting blood glucose level and 2-hour postprandial blood glucose level in the observation group were significantly lower than those in the control group before and after treatment(P<0.001).After treatment,the scores of vibration sensation,acupuncture sensation and temperature sensation of thumb in the observation group were significantly lower than those in the control group before and after treatment(P<0.001),and the motor sensory conduction velocity of median nerve and peroneal nerve in peripheral nerve of the observation group were significantly faster than those of the control group(P<0.05).There was no statistically significant difference in the total proportion of nausea and vomiting,loose stool,hypoglycemia and dizziness between the two groups(P>0.05).Conclusion Combined use of metformin on the basis of acarbose in patients with type 2 diabetic peripheral neuropathy can better control blood sugar and improve peripheral nerve function,which has less adverse reactions and high safety.