降糖药及合并用药分析

目的：了解我院降糖药及合并用药的使用情况，为临床合理用药提供参考。方法：随机提取我院2006～2008年的门诊处方，对其中舍有降糖药物的处方进行分析。结果：联合应用口服降糖药及其他药物的方法较为常见，我院使用最多的3种降糖药分别是阿卡波糖、二甲双胍和格列喹酮。结论：我院降糖药使用比较合理。     

门冬胰岛素(IASP)治疗2型糖尿病的临床疗效观察

目的:观察门冬胰岛素(IASP)治疗2型糖尿病的临床疗效。方法:对治疗的50例2型糖尿病的患者随机分为两组,分别以IASP和诺和灵R治疗4周,观察两组餐后1h、2h血糖的变化。结果:IASP和诺和灵R均可有效降低血糖,但IASP餐后1h血糖下降幅度显著大于对照组,两组空腹血糖、餐后2h血糖的水平无显著差异性,IASP治疗组低血糖发生率明显低于对照组。结论:IASP治疗2型糖尿病具有显著效果、安全性及耐性好。     

61例抗糖尿病药物不良反应报告分析

目的:分析我院抗糖尿病药物不良反应(ADR)发生的特点,为临床合理安全使用该药提供参考。方法:采用回顾性方法,对我院2009年9月～2011年9月临床上报的ADR报告进行统计分析。结果:抗糖尿病药物导致ADR病例61例,其中男30例(49.18%),女31例(50.82%);涉及药物共6类10种。ADR临床表现主要为神经系统(35.11%)、消化系统(21.28%)及心血管系统(14.89%)反应。结论:抗糖尿病药物可引发多系统的不良反应,应引起医护人员和患者的关注,注意监测。     

我院口服降糖药应用情况分析

目的分析我院2型糖尿病患者的口服降糖药应用情况,为临床用药提供参考。方法调取我院2010年1月—2012年12月住院的2型糖尿病患者服用口服降糖药的药品资料,利用Microsoft Excel软件对口服降糖药的销售数量、销售金额、用药频度和日均药费等进行统计分析。结果从2010—2012年这3年间本院口服降糖药的销售金额逐年增加,排在前两位的口服降糖药为阿卡波糖片和盐酸二甲双胍片;DDDs最高的三种药物为阿卡波糖片、格列吡嗪片和盐酸二甲双胍。结论我院住院患者口服降糖药物应用基本合理。     

液相色谱-质谱联用法检测某些降糖中药制剂中的磺酰脲类化学药

目的：建立液相色谱一电喷雾离子阱质谱联用法测定纯中药降糖药中非法掺入的格列本脲等酰脲类化学药,包括格列吡嗪、格列本脲、格列美脲、格列喹酮、格列齐特。方法：选用Agilent C18,以0．02mol·L^-1醋酸铵溶液（醋酸调节pH值至3．5）-甲醇（30：70）为流动相。根据所检测到化合物的色谱保留时间及一级、二级质谱信息,并与对照品比较,对中药制剂中非法掺入的酰脲类化学药。结论：该方法选择性强,灵敏度高,可作为分析检测非法中药制荆的有效手段。     

液相色谱-质谱联用法检测某些中药制剂中的格列本脲

目的：建立液相色谱-电喷雾离子阱质谱联用法鉴定纯中药降糖药物中非法掺入的化学降糖药格列本脲。方法：选用Zirbax Eekuose XDB-C8柱，以乙腈-水-甲酸(70：30：1)为流动相，根据所检测到化合物的色谱保留时间及多级质谱信息，并与对照品比较，对中药制剂中非法掺人的化学降糖药进行定性鉴别。结果：6种被试中药制剂中均检测到非法掺人化学药格列本脲。结论：该方法选择性强，灵敏度高，可作为分析检测非法中药制剂的有效手段。     

青钱柳降糖组方对2型糖尿病大鼠的治疗作用

目的:探讨青钱柳降糖组方(QQL组方)对2型糖尿病模型大鼠的治疗效果。方法:随机抽取10只大鼠作为正常对照组,其余大鼠采用高脂饮食联合链脲霉素诱发2型糖尿病大鼠模型。成模大鼠随机分为中药高(300 mg·kg~(-1)·d~(-1))、中(150 mg·kg~(-1)·d~(-1))、低(75 mg·kg~(-1)·d~(-1))剂量组和模型对照组,每组10只。各给药组每日给予相应药物灌胃,连续6周。观察QQL组方对糖尿病大鼠体重、血糖、血清胰岛素、糖化血红蛋白、抗氧化指标和炎症因子的影响。结果:与模型对照组比较,QQL组方中、高剂量组大鼠的体重增加,血糖下降,血清胰岛素含量升高,糖化血红蛋白含量降低,血糖曲线下面积减少,胰岛组织损伤减轻,血清SOD和GSH增加,MDA、IL-1β和TNF-α水平降低。结论:QQL组方对2型糖尿病大鼠高血糖症状和糖耐受情况有改善作用,对胰岛组织有保护作用,其机制可能与其抗氧化和抗炎作用有关。     

The association between co-morbidity and the use of antidiabetics or adjunctive cardiovascular medicines in Australian veterans with diabetes

Objective

To examine the association between co-morbidities and the use of antidiabetic medications or adjunctive cardiovascular medicines among Australian veterans with diabetes.

Methods

Data were sourced from the Australian Department of Veterans’ Affairs Health Claims database. All veterans aged 65 years and over who were dispensed medicines for diabetes from July to December 2006 were included. Dispensings of antidiabetic and adjunctive cardiovascular medicines over the first six months of 2007 were examined. Log binominal regression models were used to calculate the relative risks of the dispensing of medications for various co-morbidities, taking into account potential confounders.

Results

Among the 14,802 veterans who were dispensed medicines for diabetes, 70% had five or more co-morbidities. Patients who had diabetes-related co-morbidities had significantly less dispensing of metformin monotherapy and more dispensing of insulin than those without these conditions. Patients who had cardiovascular disease were more likely to have three or more oral antidiabetics dispensed (RR = 1.16, 95% CI: 1.04-1.30), particularly those who had heart failure (RR = 1.24, 95% CI: 1.05-1.47). Patients with renal disease were more likely to have glitazones dispensed (RR = 1.46, 95% CI: 1.24-1.72). Adjunctive cardiovascular medicines were significantly less likely to be dispensed to those with established heart conditions and non-related co-morbidities, particularly dementia.

Conclusions

Consistent with guideline recommendations, in this cohort more intensive antidiabetic and cardiovascular therapy is used in those with more severe disease as measured by related co-morbidities. Cardiovascular medicines however may be underutilised in those with un-related co-morbidities.     

中药降糖药非法添加化学药物的快速筛选方法

目的:建立中药降糖药非法添加化学药物的检测方法,并对中药降糖药中非法添加常用化药成分进行鉴定。方法:采用显微鉴别法和薄层色谱相结合的实验方法。结果:本法快速、准确、灵敏。结论:可用于降糖药非法加入化学药的检测。