二甲双胍对2型糖尿病患者大肠腺瘤术后复发的影响

Effect of oral metformin on postoperative recurrence of type 2 diabetes mellitus with colorectal adenoma

目的 探究口服二甲双胍对2型糖尿病伴大肠腺瘤术后复发的影响。方法 前瞻性纳入2019年6月至2022年6月华北医疗健康集团峰峰总医院行内镜黏膜切除术(EMR)的2型糖尿病伴大肠腺瘤患者186例,最终150例患者入组,随机字母表法分为对照组和观察组,每组75例。对照组患者术后给予营养支持等常规治疗,使用胰岛素控制血糖;观察组患者在对照组的基础上联合口服二甲双胍治疗。对比两组患者的临床疗效、血清炎症指标、复发情况及不良反应。结果 观察组术后5个月的治疗显效率和总有效率显著高于对照组(73.33%比36.00%、89.33%比60.00%,P <0.05);两组患者的血清炎症指标水平较术前均显著降低,观察组的C反应蛋白、白介素-6、白介素-8水平显著低于对照组[(4.21±0.23) mg/L比(5.13±0.11) mg/L、(4.92±2.57) pg/mL比(6.13±3.11) pg/mL、(42.14±2.52)pg/mL比(45.21±2.48) pg/mL,P<0.05]。观察组的复发率显著低于对照组(21.00%比42.67%,P<0.05);两组患者治疗期间的不良反应总发生率差异无统计学意义。结论 二甲双胍抑制2型糖尿病患者大肠腺瘤术后复发的效果显著,可进一步缓解炎症,具有较高安全性。

ObjectiveTo investigate the effect of oral metformin on postoperative recurrence of type 2 diabetes mellitus with colorectal adenoma.MethodsProspectively, 186 patients with type 2 diabetes mellitus with colorectal adenoma who underwent endoscopic mucosal resection(EMR)in Fengfeng General Hospital of North China Medical and Healthcare Group were included from June 2019 to June 2022, and finally 150 patients were enrolled and divided into the control group and the observation group by randomized alphabetical method, with 75 patients in each group.The patients in the control group were given conventional treatments such as nutritional support and insulin to control blood glucose after surgery;the patients in the observation group were treated with oral metformin on the basis of the control group.The clinical efficacy, serum inflammation index, recurrence and adverse reactions were compared between the two groups.ResultsThe treatment apparent rate 5 months after operation and total effective rate of the observation group were significantly higher than those of the control group(73.33% vs.36.00%、89.33% vs.60.00%, P<0.05). The levels of serum inflammation indexes of patients in the two groups were significantly lower compared with the preoperative period, and the C-reactive protein, interleukin-6 and interleukin-8 of the observation group were significantly lower than those of the control group [(4.21±0.23)mg/L vs.(5.13±0.11)mg/L, (4.92±2.57)pg/mL vs.(6.13±3.11)pg/mL, (42.14±2.52)pg/mL vs.(45.21±2.48)pg/mL, P<0.05]. In addition, the relapse rate in the observation group was significantly lower than that in the control group(21.00% vs.42.67%, P<0.05). Meanwhile, there was no statistically significant difference in the total incidence of adverse reactions during treatment between the two groups.ConclusionMetformin can significantly inhibit postoperative recurrence of colorectal adenoma in patients with type 2 diabetes mellitus, and can further relieve inflammation with high safety.