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目的观察动态血糖监测系统(CGMS)联合胰岛素泵(CSII)(双C方案)治疗难治性糖尿病的临床效果。方法难治性糖尿病患者70例,随机分为对照组和观察组各35例,对照组给予传统分次皮下注射胰岛素治疗,观察组采用双C方案治疗。比较两组血糖达标(晨起空腹血糖≤7.0 mmol/L、餐后2 h血糖≤10.0 mmol/L为达标)时间及胰岛素用量,治疗期间无症状低血糖事件及有症状低血糖事件发生频数。采用SPSS 15.0统计软件。计量数据以(xˉ±s)表示,两组间均数比较采用独立样本t检验;计数资料采用χ2检验或四格表Fisher精确概率法。P<0.05为差异有统计学意义。结果观察组血糖达标时间为(7.35±3.46)d、对照组为(15.43±6.11)d,P=0.00;观察组胰岛素用量(41.15±4.62)U/d、对照组为(45.27±7.13)U/d,P=0.02。治疗期间观察组无症状低血糖事件发生频次为(0.32±0.07)次/例、对照组为(0.11±0.03)次/例,P=0.01;观察组有症状低血糖事件发生频次为(0.04±0.00)次/例、对照组为(0.10±0.02)次/例,P=0.04。结论传统皮下注射多种胰岛素治疗难治性糖尿病相比,CGMS联合CSII血糖达标时间更短、胰岛素用量更少、低血糖发生率更低。
Objective To observe the clinical effect of CGMS combined with insulin pump (CSII) (double C regimen) in the treatment of refractory diabetes mellitus. Methods 70 patients with refractory diabetes mellitus were randomly divided into control group and observation group, 35 cases each. The control group was given conventional subcutaneous injection of insulin and the observation group was treated with double C regimen. The blood glucose level (morning fasting blood glucose ≤7.0 mmol / L, postprandial 2 hour blood glucose ≤10.0 mmol / L as standard) time and insulin dosage, asymptomatic hypoglycaemia and symptomatic hypoglycemic events were compared between the two groups. Using SPSS 15.0 statistical software. Measurement data to (xˉ ± s), said the two groups were compared using the independent sample t-test; count data using the χ2 test or four-table Fisher exact test. P <0.05 for the difference was statistically significant. Results The blood glucose level of the observation group was (7.35 ± 3.46) days, and that of the control group was (15.43 ± 6.11) days, P = 0.00. The insulin dosage of the observation group was 41.15 ± 4.62 U / d and that of the control group was 45.27 ± 7.13 U /d,P=0.02. The incidence of asymptomatic hypoglycaemia was (0.32 ± 0.07) times per case in the observation group and (0.11 ± 0.03) times in the control group, P = 0.01 in the treatment group. The incidence of symptomatic hypoglycemia in the observation group was (0.04 ± 0.00) times / case, the control group was (0.10 ± 0.02) times / case, P = 0.04. Conclusion Compared with traditional subcutaneous injection of insulin for refractory diabetes, CGMS combined with CSII has shorter blood glucose compliance time, less insulin dosage and lower incidence of hypoglycemia.