阿卡波糖与瑞格列奈联合二甲双胍治疗2型糖尿病餐后高血糖的效果观察

摘 要 目的：比较阿卡波糖与瑞格列奈分别联合二甲双胍治疗2型糖尿病餐后高血糖的效果。方法: 160例餐后高血糖的糖尿病患者随机分为阿卡波糖组与瑞格列奈组，每组80例。分别给予阿卡波糖联合二甲双胍治疗与瑞格列奈联合二甲双胍治疗8周。比较两组治疗前后血糖、糖化血红蛋白（HbA1c）、胰岛素、血脂与体质指数（BMI）等指标的变化，以及两组药品不良反应发生情况。结果: 治疗后，两组患者空腹血糖（FPG）、餐后2 h血糖（2hPG）及HbA1c水平均较治疗前明显降低（P<0.05），且瑞格列奈组FPG水平明显低于阿卡波糖组（P<0.05）。治疗后，瑞格列奈组空腹胰岛素、餐后2 h胰岛素水平均较治疗前明显上升（P<0.05），而阿卡波糖组则较治疗前明显降低（P<0.05）；两组间比较差异有统计学意义（P<0.05）。治疗后，阿卡波糖组三酰甘油、低密度脂蛋白胆固醇水平和BMI均较治疗前明显降低（P<0.05），而瑞格列奈组上述指标治疗前后比较差异无统计学意义（P＞0.05）；两组间比较差异有统计学意义（P<0.05）。瑞格列奈组药品不良反应发生率明显低于阿卡波糖组（P<0.05）。结论:阿卡波糖与瑞格列奈联合二甲双胍均降低2型糖尿病患者餐后高血糖，瑞格列奈降低FPG作用优于阿卡波糖，而阿卡波糖能使患者餐后胰岛素、血脂及BMI降低，对肥胖患者更为适合。

Clinical Efficacy of Acarbose or Repaglinide Combined with Melbine in the Treatment of Postprandial Hyperglycemia of Type 2 Diabetes

ABSTRACT Objective: To compare the efficacy of acarbose or repaglinide combined with melbine in the treatment of postprandial hyperglycemia of type 2 diabetes. Methods:A total of 160 patients with postprandial hyperglycemia of type 2 diabetes were divided into two groups with 80 ones in each, which was respectively treated with acarbose combined with melbine and repaglinide combined with melbine. The course of treatment was 8 weeks. The blood glucose before and after the treatment, glycosylated hemoglobin(HbA1C), blood lipid, body mass index (BMI) and adverse drug reactions were compared between the two groups. Results:After the treatment, the fasting blood glucose (FPG), 2h postprandial glucose (2hPG) and the level of HbA1c in the two groups were significantly decreased when compared with those before the treatment (P<0.05), and FPG was lower in repaglinide group than that in acarbose group (P<0.05). The fasting insulin and 2h postprandial insulin in repaglinide group were significantly increased after the treatment (P<0.05) , while those in acarbose group were notably decreased (P<0.05), and the differences between the two groups were statistically significant (P<0.05). Compared with those before the treatment, the levels of triglyceride, low density lipoprotein and BMI in acarbose group were decreased significantly (P<0.05) after the treatment, while those showed no notable changes in repaglinide group (P>0.05), and the differences between the two groups were statistically significant (P<0.05). The incidence of adverse drug reactions in repaglinide group was much lower than that in acarbose group (P<0.05). Conclusion: Acarbose or repaglinide combined with melbine both can decrease postprandial blood glucose in the patients with type 2 diabetes, and the effect of repaglinide on FPG is better than that of acarbose, while acarbose can reduce postprandial insulin, blood lipid and BMI, which is more suitable for obese patients.