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目的:探讨二甲双胍对肥胖型2型糖尿病患者相关指标的影响。方法:136例肥胖型2型糖尿病患者随机均分为对照组和观察组。所有患者均完善常规检查,进行糖尿病常规教育,控制饮食、加强运动锻炼。在此基础上,对照组患者给予格列齐特片(Ⅱ)80 mg,每日1次,并实时监测血糖水平,根据空腹血糖水平调整用药量,使空腹血糖达到3.9~6.1 mmol/L;观察组患者给予二甲双胍肠溶片0.5 g,每日2次。两组均治疗12周后比较。观察两组患者治疗前后糖化血红蛋白(Hb A1c)、体质量指数(BMI)、抵抗素、胰岛素样生长因子1(IGF-1)及相关炎症因子[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)]水平,并记录不良反应发生情况。结果:治疗后,两组患者抵抗素、IGF-1、IL-6、hs-CRP水平均显著低于同组治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05);观察组患者BMI、IL-1β、TNF-α水平均显著低于同组治疗前和对照组,差异均有统计学意义(P<0.05);两组患者Hb A1c水平均显著低于同组治疗前,差异均有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:二甲双胍能够改善肥胖型2型糖尿病患者的胰岛素抵抗,抑制炎症反应。
Objective: To investigate the effect of metformin on related indicators in obese type 2 diabetic patients. Methods: 136 obese type 2 diabetic patients were randomly divided into control group and observation group. All patients were perfect routine examination, routine diabetes education, diet control, and exercise training. On this basis, patients in the control group were given gliclazide 80 mg once daily, and the blood glucose level was monitored in real time. The fasting blood glucose level was adjusted to 3.9-6.1 mmol / L according to the fasting blood glucose level. Patients in the observation group were given metformin 0.5 g twice daily. The two groups were compared after 12 weeks of treatment. The levels of Hb A1c, body mass index (BMI), resistin, insulin-like growth factor 1 (IGF-1) and related inflammatory cytokines [interleukin (IL) -1β and IL-6 , Tumor necrosis factor (TNF) -α, hs-CRP) were measured and the incidence of adverse reactions was recorded. Results: After treatment, the levels of resistin, IGF-1, IL-6 and hs-CRP in both groups were significantly lower than those in the same group before treatment, and the levels in the observation group were lower than those in the control group (P < 0.05). The levels of BMI, IL-1β and TNF-α in the observation group were significantly lower than those before treatment and in the control group (P <0.05), and the levels of Hb A1c in both groups were significantly lower than those in the control group The difference between the two groups was statistically significant (P <0.05), but there was no significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05) . Conclusion: Metformin can improve insulin resistance and suppress inflammation in obese type 2 diabetic patients.