那格列奈与阿卡波糖治疗2型糖尿病疗效对比研究

目的观察那格列奈与阿卡波糖治疗2型糖尿病患者的临床疗效。方法66例2型糖尿病患者随机分为那格列奈组34例及阿卡波糖组32例，疗程为12周。定期测定并比较2组治疗前后空腹血糖（FPG）、餐后2h血糖（P2hBG），糖化血红蛋白（HbAlc），空腹及餐后2h胰岛素（FINS，P2hINS），血脂和体质量指数（BMI）。结果2组FPG、P2hBG、HbAlc均明显降低（P〈0．01），那格列奈组治疗后FPG低于阿卡波糖组（P〈0．05）；那格列奈组治疗后FINS、P2hINS均升高（P〈0．05和P〈0．01），阿乍波糖FINS、P2hINS降低（P〈0．01），2组比较差异有统计学意义（P〈0．01）；治疗后那格列奈组BMI上升（P〉0．05），阿卡波糖组下降（P〈0．05），且明显低于那格列奈组（P〈0．05）；阿卡波糖组治疗后三酰甘油（TG）和低密度脂蛋白（LDL—C）明显降低（P〈0．01），与那格列奈组比较差异有统计学意义（P〈0．01）。结论那格列奈和阿卡波糖均有明显降低FBG、P2hINS以及HbAlc的作用，对以餐后血糖高为主的糖尿病患者更适合选用。那格列奈降空腹血糖的作用优于阿卡波糖，而阿卡波糖可减低餐后胰岛素分泌，调节血脂，减轻体质量，更适合肥胖患者。

Comparative study on the therapeutic efficacy of nateglinide versus acarbose in treatment of type 2 diabetes mellitus patients

Objective To compare clinical therapeutic efficacy of the nateglinide and acarbose in the type 2 diabetes mellius patients. Methods 66 patients with type 2 diabetes mellitus were randomly divided into two groups and treated for 12 weeks either with nateglinide（ n = 34 ） or acarbose （ n = 32 ） respectively. The values of FPG, P2hBG, HbAI c, FINS, P2hINS, blood-fat and BMI were periodically measured and compared before and after treatment. Results The concentrations of FPG decreased both in nateglinide group and aearbose group（ P 〈0.01 ） ,and nateglinide group was lower than the acarbose group （P 〈 0.05 ） ;Both drugs could reduce the value of P2hBG significantly （P 〈 0.01 ） , which had similar effects as well;The levels of HbA1c were significantly decreased in the two groups（ P 〈 0.01 ） ;The values of P2hINS eompared with those in nateglinide group before treatment,but were significantly decreased（ P 〈 0.01 and P 〈 0.05 ）in aearbose group after treatment, BMI was slightly increased in Nateglinide group（ P 〉 0.05 ） and decreased in acarbose （ P 〈 0.05 ）, showing significant difference between the two groups（P 〈0.05 ）. Triglyceride and low-density lipoprotein significantly clecreased after treatment in acarbose group, and lower than that of nate linde group（ P 〈 0.01 ）. Conclusion The values of FPG,P2hBGand HbA1c are significantly decreased in both groups. Nateglinide and acarbose are more suitable for treatment of patients whose value of P2hBG were increased apparently after diet. The effects of Nateglinide is better than acarboae in reduce FPG. Acabose has the effeet of reducing postprandial insulin secretion,regulating blood-fat and losing body weight,thus is more suitable to obese type 2 diabetics.