CAJ | 학술논문

目的：探讨慢性乙型肝炎合并糖尿病的治疗方法。方法选取本院传染区2008年1月-2012年12月住院的慢性乙型肝炎合并糖尿病患者68例，按治疗方法分为治疗组41例、对照组27例。在常规护肝基础上，对照组以诺和锐30控制血糖，治疗组则以诺和锐联合茵陈蒿汤加减方控制血糖。治疗期间定时检测肝功能、血糖水平、糖化血红蛋白，统计肝功能复常时间，记录并统计每例患者低血糖事件次数及胰岛素日用量。治疗前后及组间均数比较使用t检验。结果治疗后2组肝功能均较前显著改善（P＜0．01），血糖水平、糖化血红蛋白较前显著下降（P＜0．01）。其中治疗后，治疗组糖化血红蛋白（6．3％±0．6％）较对照组（7.3％±0.5％）更接近正常且差异有统计学意义（t＝7．46，P＜0．01）。治疗组肝功能复常时间[（28．7±5．61）d]短于对照组[（35．5±6．33）d]且差异有统计学意义（t＝4．53，P＜0．01）。低血糖事件治疗组为（0．8±0．3）次/例，显著低于对照组（2．2±0．8）次/例（t＝8．78，P＜0．01）。胰岛素日用量治疗组为（37．4±5．2）U，低于对照组（44．6±6．5）U，2组比较差异有统计学意义（t＝4.86，P＜0．01）。结论诺和锐联合茵陈蒿汤加减方是治疗慢性乙型肝炎合并糖尿病的经济、有效、安全的方法。
목적：탐토만성을형간염합병당뇨병적치료방법。방법선취본원전염구2008년1월-2012년12월주원적만성을형간염합병당뇨병환자68례，안치료방법분위치료조41례、대조조27례。재상규호간기출상，대조조이낙화예30공제혈당，치료조칙이낙화예연합인진호탕가감방공제혈당。치료기간정시검측간공능、혈당수평、당화혈홍단백，통계간공능복상시간，기록병통계매례환자저혈당사건차수급이도소일용량。치료전후급조간균수비교사용t검험。결과치료후2조간공능균교전현저개선（P＜0．01），혈당수평、당화혈홍단백교전현저하강（P＜0．01）。기중치료후，치료조당화혈홍단백（6．3％±0．6％）교대조조（7.3％±0.5％）경접근정상차차이유통계학의의（t＝7．46，P＜0．01）。치료조간공능복상시간[（28．7±5．61）d]단우대조조[（35．5±6．33）d]차차이유통계학의의（t＝4．53，P＜0．01）。저혈당사건치료조위（0．8±0．3）차/례，현저저우대조조（2．2±0．8）차/례（t＝8．78，P＜0．01）。이도소일용량치료조위（37．4±5．2）U，저우대조조（44．6±6．5）U，2조비교차이유통계학의의（t＝4.86，P＜0．01）。결론낙화예연합인진호탕가감방시치료만성을형간염합병당뇨병적경제、유효、안전적방법。
Objective To investigate the treatment methods for chronic hepatitis B (CHB)with diabetes.Methods Sixty-eight patients with CHB accompanied by diabetes who were hospitalized in the division of infectious diseases of our hospital from January 2008 to December 2012 were included in the study.These patients were divided into treatment group (n=41)and control group (n=27)based on treatment methods.In addition to conventional liver protection treatment,NovoRapid 30 was given to the control group,while NovoRapid 30 combined with modified Yinchenhao decoction were given to the treatment group.During treatment,liver function,blood glucose levels,and glycosy-lated hemoglobin levels were monitored periodically;liver function recovery time was analyzed statistically;the incidence of hypoglycemia for each patient and daily dose of insulin were recorded and analyzed statistically.Before-after comparison and between-group comparison of means were made by t test.Results After treatment,both groups showed a significant improvement in liver function (P<0.01)and signif-icant decreases in blood glucose and glycosylated hemoglobin levels (P<0.01);the treatment group had a significantly lower glycosylated hemoglobin level than the control group (6.3%±0.6% vs 7.3%±0.5%,t=7.46,P<0.01 ).Compared with the control group,the treatment group had a significantly shorter liver function recovery time (28.7 ±5.61 days vs 35.5 ±6.33 days,t=4.53,P<0.01),a sig-nificantly lower incidence of hypoglycemia (0.8 ±0.3 times/patient vs 2.2 ±0.8 times/patient,t=8.78,P<0.01 ),and a significantly lower daily dose of insulin (37.4 ±5.2 U vs 44.6 ±6.5 U,t=4.86,P<0.01).Conclusion Combination therapy with NovoRapid and modified Yinchenhao decoction is an effective,safe,and economical approach to the treatment of CHB with diabetes.