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

Effect of Vitamin B_(12) and Folic acid Combined with Metformin on Type 2 Diabetes Mellitus and Its Effect on Homocysteine

目的通过临床实践,研究维生素B_(12)、叶酸、二甲双胍这三种药剂同时作用时,对比单独使用二甲双胍治疗2型糖尿病的效果差异。同时,分析同型半胱氨酸的作用机制进而研究其对2型糖尿病并发症的影响。方法自2014年5月起至2015年11月,将我院不断的收治2型糖尿病患者按照1∶1的比例分组,一组作为对照组,只注射二甲双胍进行治疗;另一组除注射二甲双胍外,同时服用一定剂量的维生素B_(12)叶酸,作为观察组。在治疗前后均对患者的维生素B_(12)、叶酸、同型半胱氨酸水平进行抽血检测做记录,在一定时间后观察2型糖尿病的治疗效果。在此期间共获得患者132例,对照组观察组各记录数据66例。结果在住院治疗之前,两组患者的抽血检测结果显示维生素B_(12)、叶酸和同型半胱氨酸水平几乎无差异。在入院分组治疗以后,发现对照组患者的维生素B_(12)、叶酸体内含量较治疗之前出现了明显下降的情况,而同型半胱氨酸的含量明显上升(P<0.05);而通过对比住院前后的采集数据,观察组的上述指标均无显著变化(P>0.05),同时观察组患者2型糖尿病的并发症发生概率大大低于对照组,这种差异具有统计学意义(P<0.05)。结论对于2型糖尿病患者的治疗,仅采用二甲双胍容易引发并发症的发生,而联合使用维生素B_(12)和叶酸能在保持治疗效果的同时保持体内同型半胱氨酸的稳定,以降低2型糖尿病患者并发症的发病概率,此种方法应在临床实践中大力推广。

Objective To study the effect of vitamin B_(12), folic acid and metformin in the treatment of type 2 diabetes by comparing the effects of the three drugs at the same time. At the same time, to analyze the mechanism of homocysteine and its influence on the complications of type 2 diabetes mellitus. Methods From May 2014 to November 2015 in our hospital were constantly in patients with type 2 diabetes according to the ratio of 1∶1 group, a group as the control group, only injection of Metformin; the other groups except injection of metformin, while taking a certain dose of vitamin B_(12) folic acid, as the observation group. Before and after the treatment of patients with vitamin B_(12), folic acid, homocysteine levels were recorded blood test, after a certain period of time to observe the therapeutic effect of type 2 diabetes. During this period, a total of 132 patients were enrolled in the control group, and the data of each group were recorded in the observation group(n=66). Results Before hospitalization, two groups of patients with blood test results showed that vitamin B_(12), folic acid and homocysteine levels were almost no difference. In the hospital group after treatment, found that patients in the control group of vitamin B_(12), folic acid content in vivo compared with before treatment there has been a marked decline, while the content of homocysteine increased significantly(P <0.05); and through the comparison of hospital before and after the data collection, there were no significant changes in the index of the observation group(P >0.05). At the same time, the observation group of patients with type 2 diabetes complication rate significantly lower than the control group, the difference was statistically significant(P <0.05). Conclusion For the treatment of patients with type 2 diabetes with metformin only, prone to complications, and the combined use of vitamin B_(12) and folic acid can maintain the treatment effect and maintain the body of homocysteine is stable, in order to reduce the complications in patients with type 2 diabetes disease probability, this method should be popularized in clinical practice.