阿卡波糖对糖耐量减低患者踝臂指数的影响

目的：观察阿卡波糖对糖耐量减低（IGT）患者踝臂指数（ABI）的影响。方法：IGT患者随机分为两组,在控制饮食、适当运动的基础上,实验组口服阿卡波糖50mg,每天3次,持续1年。比较两组餐后2h血糖、糖化血红蛋白、踝臂指数、IMT。受试者均行75g口服葡萄糖耐量试验（OGTT）。结果：与血糖正常者（NGT）相比,IGT组踝臂指数下降（P〈0.05）。实验组治疗1年后餐后2h血糖、糖化血红蛋白均下降（P〈0.05）,踝臂指数下降,IMT增加（P〉0.05）。实验组治疗后餐后2h血糖、糖化血红蛋白、IMT均低于对照组（P〈0.05）,踝臂指数高于对照组（P〈0.05）。踝臂指数与餐后2h血糖呈负相关（r=-0.27,P〈0.05）。结论：阿卡波糖能防止IGT患者踝臂指数下降,延缓周围血管病变的发生。     

甘精胰岛素联合阿卡波糖治疗2型糖尿病的疗效观察

目的：探讨甘精胰岛素联合阿卡波糖治疗2型糖尿病的临床效果。方法方便选取2012年10月—2013年12月期间在该院收治的2型糖尿病患者100例,随机分为研究组和对照组(每组50例)。研究组采用甘精胰岛素联合阿卡波糖治疗,对照组给予预混胰岛素(诺和灵30R)治疗。治疗周期均为12周,治疗后观察两组治患者空腹血糖(FBG)、餐后2 h血糖(2 h PBG)糖化血红蛋白(HbAlc)的变化、低血糖发生率及胃肠道不良反应。结果两组治疗后患者FBG、2 h PBG HbAlc均明显降低,其中治疗后两组FBG,HbAlc水平比较差异无统计学意义(P>0.05),两组患者2 h PBG水平比较差异具有统计学意义(P<0.05);研究组和对照组低血糖发生率分别为3例(6.0%)和10例(20.0%),两组比较差异具有统计学意义(P<0.05)。结论甘精胰岛素联合阿卡波糖能较好的控制2型糖尿病患者的血糖,且患者低血糖发生率低,值得临床推广使用。     

甘精胰岛素联合阿卡波糖对初发2型糖尿病患者氧化应激的影响

目的：观察甘精胰岛素联合阿卡波糖用于初发2型糖尿病（T2DM）患者的疗效及对氧化应激的影响。方法：选取24例初发2型糖尿病患者,比较其治疗前后空腹血糖（FBG）、餐后血糖（PBG）、）、总胆固醇（TC）、三酰甘油（TG）、糖化血红蛋白（HbAlc）、血浆超氧化物歧化酶（SOD）、丙二醛（MDA）等相关指标,同时选择性别年龄相匹配的健康体检者20名作为对照,分析这些指标在治疗前后的变化。结果：24例受试者治疗前后的FBG、PBG、TC、TG及HbAlc含量的变化均有统计学意义（P〈0．05）,治疗后血SOD水平较治疗前明显升高（P〈0．05）,MDA水平较治疗前明显下降（P〈0．05）,较健康正常人比较,SOD水平仍较低,MDA水平仍较高（P〈0．05）。结论：应用甘精胰岛素联合阿卡波糖治疗2型糖尿病,在降低血糖、血脂的同时,可以减轻2型糖尿病患者体内的氧化应激水平。     

Pharmacology of α-glucosidase inhibition

The development of α-amylase and brush-border α-glucosidase inhibitors is reviewed. The mode of action as well as pharmacological and pharmacodynamic properties of selected inhibitors with special regard to the most thoroughly investigated α-glucosidase inhibitor acarbose are discussed. Inhibition of intestinal α-glucosidases delays the digestion of starch and sucrose, flattens the postprandial blood glucose excursions, and thus mimics the effects of dieting on hyperglycaemia, hyperinsulinaemia and hypertriglyceridaemia. Therefore, the mechanism of α-glucosidase inhibition represents the pharmacological optimization of the dietary principle of delayed carbohydrate absorption. In pre-clinical studies using diabetic animals the oral administration of acarbose improved the metabolic state and reduced the blood glucose area under the curve. As a consequence, the process of non-enzymatic glycation of proteins was retarded as indicated by reduced glycated haemoglobin, glomerular basement membranes or advanced glycation end-products (AGEs) in collagen. These improved biochemical parameters correlated with beneficial effects against the development of diabetic nephropathy and neuropathy. Thus, the treatment of diabetic animals with acarbose does not only improve the metabolic state but has also the potential to delay, or possibly prevent, the development of diabetic complications.     

阿卡波糖对糖耐量受损者糖尿病和心血管疾病的预防作用

为评价药物干预对糖耐量受损(IGT)者的糖尿病和心血管疾病的预防作用,对116例IGT患者进行3年的临床观察,结果发现,阿卡波糖干预组糖尿病及冠心病的发病率低于对照组。     

益气养阴汤联合西药治疗高龄2型糖尿病随机平行对照研究

[目的]观察益气养阴汤联合西药治疗高龄2型糖尿病疗效。[方法]使用随机平行对照方法,将48例门诊患者按随机数字表法分为两组。对照组24例甘精胰岛素,8IU/次,睡前皮下注射;拜糖平,50mg/次,3次/d,口服。治疗组24例益气养阴汤(黄芪、地黄各30g,丹参15g,山药、人参、白术、白芍各12g,泽泻、黄芩各10g,甘草6g),1剂/d,水煎300mL,早晚口服。西医治疗同对照组。连续治疗90d为1疗程。观测临床症状、血糖指标、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效15例,有效7例,无效2例,总有效率91.67%。对照组显效9例,有效10例,无效5例,总有效率79.17%。治疗组疗效优于对照组(P0.05)。血糖指标(FBG、P2hPG、HbA1-c)两组均有改善(P0.05),治疗组改善优于对照组(P0.05)。[结论]益气养阴汤联合西药治疗高龄2型糖尿病效果显著,值得推广。     

利拉鲁肽联合阿卡波糖治疗2型糖尿病的护理效果分析

目的探讨利拉鲁肽联合阿卡波糖治疗2型糖尿病的护理效果情况。方法分析我院内分泌科2012年3月～2013年6月收治的2型糖尿病患者应用利拉鲁肽联合阿卡波糖治疗的80例临床资料,依据护理措施不同进行临床随机分组,对照组（糖尿病的常规护理组）40例和观察组（糖尿病的特殊护理组）40例。结果两组2型糖尿病患者一般资料中的性别构成、年龄分布、病程长短情况无明显差异（χ^22=0.09,t=0.35、1．38）,观察组2型糖尿病患者整体护理质量评分、护理人员行为评分明显优于对照组（t=9．34、6．69）,观察组对于自我认知、治疗环境、病情控制感、自信心评分明显优于对照组,差异均有统计学意义（t=20．74、12．50、14．91、21．73,P〈0.05）。结论利拉鲁肽联合阿卡波糖治疗2型糖尿病同时结合特殊护理措施,可以有效地提高临床治疗效果,值得临床推广应用。     

阿卡波糖联合诺和锐30治疗肝源性糖尿病的疗效观察

目的观察阿卡波糖联合诺和锐30治疗肝源性糖尿病的疗效。方法肝源性糖尿病患者46例,随机分为两组,每组23例,治疗组在早、晚餐前30 min皮下注射诺和锐30（12-40 U/d）及口服阿卡波糖片50 mg,1-3次/d;对照组仅给予诺和锐30治疗,用法与治疗组相同。比较两组空腹血糖（FBG）、餐后2 h血糖（2hPG）及糖化血红蛋白（HbA1c）水平。结果两组患者治疗后FBG、2hPG及HbA1c水平与治疗前相比均明显下降（P〈0.05）;治疗后两组FBG水平比较,差异无统计学意义（P〉0.05）;治疗后,治疗组2hPG及HbA1c水平均明显低于对照组（P均〈0.05）。结论阿卡波糖联合诺和锐30治疗肝源性糖尿病,可以有效降低患者的2hPG、HbA1c水平。     

西格列汀联合阿卡波糖治疗Ⅱ型糖尿病对脂代谢紊乱与胰岛素抵抗的影响

【摘要】目的 探讨西格列汀联合阿卡波糖治疗Ⅱ型糖尿病及对脂代谢紊乱与胰岛素抵抗的影响。方法 118例Ⅱ型糖尿病患者依据抽签法分为对照组与实验组,各59例。对照组采用西格列汀治疗,实验组采用西格列汀联合阿卡波糖治疗。比较两组治疗3个月后疗效,并检测三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）,胰岛素抵抗指数（HOMA IR）,血糖,胃肠激素,炎症因子的改变及不良反应情况。结果〓实验组总有效率高于对照组,差异有统计学意义（P＜0.05）。实验组TG、TC、LDL-C均低于对照组,实验组HDL-C高于对照组（P＜0.05）。实验组HOMA IR低于对照组（P＜0.05）。实验组血糖、胃肠激素、炎症因子优于对照组（P＜0.05）。两组不良反应比较差异无统计学意义（P＞0.05）。结论〓西格列汀联合阿卡波糖用于Ⅱ型糖尿病的疗效肯定,可改善脂代谢紊乱及胰岛素抵抗,并可利于胃肠道激素及炎性因子的调节,可在临床上推广应用。     

Pharmacodynamic comparison of two formulations of Acarbose 100-mg tablets

What is known and Objective: Acarbose, an α‐glycosidase inhibitor, is used to treat diabetic patients. Pharmacokinetic evaluation of acarbose is difficult because <2% is absorbed systemically. The current investigation evaluated the bioequivalence of two formulations of acarbose through pharmacodynamic comparison. Methods: This investigation consisted of a pilot study and a main study. The pilot study had an open, single‐dose, single‐sequence design. Subjects received placebo and then two tablets of reference formulation (Glucobay^® 100 mg tablet; Bayer Healthcare) on two consecutive days with sucrose. The main study was an open, randomized, two‐period, two‐sequence crossover study. Subjects randomly received placebo and two tablets of either test formulation (generic acarbose 100‐mg tablet) or reference formulation with sucrose on two consecutive days in the first period. In the second period, placebo and alternative formulation were administered. Serial blood samples for pharmacodynamic assessment were taken after each administration. The maximum serum glucose concentration (G_max) and the area under the serum glucose concentration–time profile (AUC_gluc) were determined and compared. Results and Discussion: Five subjects completed the pilot study. The AUC_gluc from dosing until 1 h post‐dose (AUC_{gluc,1 h}) was significantly different between the placebo and acarbose. A total of 33 subjects completed the main study. The mean differences in G_max (ΔG_max) and AUC_{gluc,1 h} (ΔAUC_{gluc,1 h}) for the reference formulation compared with placebo were 22·0 ± 18·3 mg/dL and 928·2 ± 756·0 mg min/dL, respectively. The corresponding values for the test formulation were 23·3 ± 21·2 mg/dL and 923·0 ± 991·4 0 mg min/dL, respectively. The geometric mean ratios (GMRs) of the test formulation to the reference formulation for ΔG_max and ΔAUC_{gluc,1 h} were 1·06 and 1·00, respectively, and the 90% confidence intervals (CIs) corresponding values were 0·79–1·39 and 0·64–1·36, respectively. What is new and Conclusion: The 90% CIs of GMRs for the pharmacodynamic parameters chosen for bioequivalence evaluation of two formulations of acarbose did not meet the commonly accepted regulatory criteria for bioequivalence (0·80–1·25).