CAJ | 학술논문

目的：比较2型糖尿病合并精神分裂症患者单用二甲双胍血糖控制不佳时加用阿卡波糖或吡格列酮的疗效和安全性。方法103例单用二甲双胍血糖控制不佳的2型糖尿病合并精神分裂症患者随机分为阿卡波糖组52例和吡格列酮组51例。阿卡波糖组采用二甲双胍+阿卡波糖治疗，吡格列酮组采用二甲双胍+吡格列酮治疗，疗程均为24周。两组治疗前后检测血糖、血脂指标，测量体质量和血压，记录低血糖等不良反应情况并进行对比。结果疗程结束后，两组空腹血糖(FPG)、糖化血红蛋白(HbA1c)均低于治疗前(P<0.05)；餐后2 h血糖(2 h PG)降幅阿卡波糖组大于吡格列酮组， FPG降幅吡格列酮组大于阿卡波糖组(P<0.05)；体质量方面，阿卡波糖组体质量下降，吡格列酮组体质量增加，差异均具有统计学意义(P<0.05)；两组血压、肝肾功能指标比较差异均有统计学意义(P<0.05)；不良反应发生率比较，差异无统计学意义(P>0.05)。结论单用二甲双胍血糖控制不佳的2型糖尿病合并精神分裂症患者加用阿卡波糖或吡格列酮均能有效控制血糖，且安全性良好；但在降低2 h PG方面阿卡波糖优于吡格列酮，降低FPG方面吡格列酮优于阿卡波糖。
목적：비교2형당뇨병합병정신분렬증환자단용이갑쌍고혈당공제불가시가용아잡파당혹필격렬동적료효화안전성。방법103례단용이갑쌍고혈당공제불가적2형당뇨병합병정신분렬증환자수궤분위아잡파당조52례화필격렬동조51례。아잡파당조채용이갑쌍고+아잡파당치료，필격렬동조채용이갑쌍고+필격렬동치료，료정균위24주。량조치료전후검측혈당、혈지지표，측량체질량화혈압，기록저혈당등불량반응정황병진행대비。결과료정결속후，량조공복혈당(FPG)、당화혈홍단백(HbA1c)균저우치료전(P<0.05)；찬후2 h혈당(2 h PG)강폭아잡파당조대우필격렬동조， FPG강폭필격렬동조대우아잡파당조(P<0.05)；체질량방면，아잡파당조체질량하강，필격렬동조체질량증가，차이균구유통계학의의(P<0.05)；량조혈압、간신공능지표비교차이균유통계학의의(P<0.05)；불량반응발생솔비교，차이무통계학의의(P>0.05)。결론단용이갑쌍고혈당공제불가적2형당뇨병합병정신분렬증환자가용아잡파당혹필격렬동균능유효공제혈당，차안전성량호；단재강저2 h PG방면아잡파당우우필격렬동，강저FPG방면필격렬동우우아잡파당。
Objective To compare the curative effect and safety of acarbose or pioglitazone in the treatment of type 2 diabetes mellitus complicated with schizophrenia under poor metformin monotherapy control. Methods A total of 103 patients of type 2 diabetes mellitus complicated with schizophrenia under poor metformin monotherapy control were randomly divided into acarbose group with 52 cases and pioglitazone group with 51 cases. The acarbose group received metformin+acarbose for treatment, and the pioglitazone group received metformin+pioglitazone. Treatment lasted for 24 weeks. Blood glucose and blood lipid were detected before and after treatment in the two groups, and their body mass and blood pressure were recorded. Adverse reactions as hypoglycemia were recorded for comparison.Results After treatment, both groups had lower fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) than those before treatment (P<0.05). The acarbose group had more lowered level of 2 h postprandial blood glucose (2 h PG) than the pioglitazone group, while the pioglitazone group had more lowered level of FPG than the acarbose group (P<0.05). The acarbose group had decreased body mass, while the pioglitazone group had increased one, and their difference had statistical significance (P<0.05). The differences of blood pressure and hepatorenal function between the two groups all had statistical significance (P<0.05). There was no statistically significant difference of incidence of adverse reactions between the two groups (P>0.05).Conclusion Implement of acarbose or pioglitazone can effectively control blood glucose with high safety in the treatment of type 2 diabetes mellitus complicated with schizophrenia under poor metformin monotherapy control. Acarbose provides better effect in reducing 2 h PG than pioglitazone, while pioglitazone’s effect in reducing FPG is better than acarbose.