Vit B12联合叶酸改善2型糖尿病患者二甲双胍服用不良反应的临床研究

目的 观察Vit B₁₂与叶酸对长期服用二甲双胍的2型糖尿病患者不良反应的缓解作用。方法 回顾性收集子洲县第二人民医院2015年4月至2018年3月期间收治入住的164例2型糖尿病患者作为研究对象,平时均使用二甲双胍控制血糖,将其中额外服用Vit B₁₂和叶酸的92例患者设为观察组,剩余单纯二甲双胍治疗的72例患者设为对照组,对比分析两组患者的临床资料,长期服用药物的不良反应情况,血清Vit B₁₂、叶酸、同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)及还原型谷胱甘肽(GSH)水平。结果 两组患者在年龄、性别、家族史、平均病程及平均疗程中未见显著差异(P＞0.05),提示两组资料具有可比性。两组患者服药不良反应结果显示,与对照组相比,观察组患者腹胀、头痛及恶心的发生率显著降低,具有统计学意义(P＜0.05);而呕吐及低血糖中的发生率无显著性差异(P＞0.05)。血清相关指标结果显示,观察组Vit B₁₂、叶酸、Hcy、SOD及GSH水平分别为(351.17±65.42)pmol/L、(5.33±1.26)μg/L、(107.29±36.92)ng/L、(62.69±21.05)×10³U/L及(152.08±33.09)mg/L;对照组Vit B₁₂、叶酸、Hcy、SOD及GSH水平分别为(402.61±72.09)pmol/L、(3.91±1.03)μg/L、(146.77±45.09)ng/L、(86.47±22.63)×10³U/L及(192.71±36.95)mg/L;两组患者在Vit B₁₂、叶酸、Hcy、SOD及GSH水平中均具有显著差异(P＜0.05)。结论 协同服用Vit B₁₂与叶酸能够有效降低二甲双胍长期服用带来的不良反应,以腹胀、头痛及恶心为主;该作用可能与Vit B₁₂与叶酸协同机体代谢降低Hcy和提高SOD及GSH水平,降低氧化应激反应有关,为临床上长期服用二甲双胍患者降低不良反应,提高生活质量带来新的实验依据和干预手段。

Clinical study of Vit B12 combined with folic acid in improving the side effects of metformin in patients with type 2 diabetes

Objective To observe the alleviation effect of Vit B₁₂ and folic acid on side effects of type 2 diabetes patients with long-term metformin.Methods A retrospective collection of 164 patients with type 2 diabetes who were admitted to our hospital from April 2015 to March 2018 was used as a study subject.Metformin was used to control blood glucose.92 patients with additional Vit B₁₂ and folic acid were enrolled in the observation group,and 72 patients with metformin alone were used as the control group.The clinical data of the two groups were compared.The side-effects of long-term medication,serum Vit B₁₂,folic acid,homocysteine,superoxide dismutase (SOD) and reduced glutathione (GSH) levels.Results There were no significant differences in age,gender,family history,mean duration of disease,and mean course of treatment between the two groups (P＞0.05),suggesting that the data were comparable.The side effects of the two groups of patients showed that compared with the control group,the incidence of abdominal distension,headache and nausea was significantly lower in the observation group (P＜0.05),while the incidence in vomiting and hypoglycemia was not significant.Difference (P＞0.05).Serum related indicators showed that the levels of Vit B₁₂,folic acid,Hcy,SOD and GSH in the observation group were (351.17±65.42) pmol/L,(5.33±1.26) μg/L,(107.29±36.92) ng/L,(62.69)±21.05)×10³U/L and (152.08±33.09) mg/L; the levels of Vit B₁₂,folic acid,Hcy,SOD and GSH in the control group were (402.61±72.09) pmol/L and (3.91±1.03) μg/L,(146.77±45.09) ng/L,(86.47±22.63) ×10³U/L and (192.71±36.95) mg/L respectively.There were significant differences in Vit B₁₂,folic acid,Hcy,SOD and GSH levels between the two groups (P＜0.05).Conclusion Synergistic administration of Vit B₁₂ and folic acid can effectively reduce the side effects caused by long-term use of metformin,mainly bloating,headache and nausea; this effect may be combined with Vit B₁₂ and folic acid metabolism to reduce Hcy and increase SOD and GSH levels,reduce oxidative stress The response is related to the clinical long-term use of metformin patients to reduce side effects and improve the quality of life to bring new experimental basis and intervention.