CAJ | 학술논문

目的：探讨近日节律法口服降糖药物干预2型糖尿病( T2DM)患者的临床效果及安全性。方法选取2013年4~7月东莞市沙田医院收治的120例社区T2DM患者为研究对象，依据随机数字表法分为对照组和观察组，各60例。对照组给予常规二甲双胍0．5 g三餐前口服治疗，观察组给予血糖监测，找到每例患者特有的血糖近日节律规则，制订个性化定时药物治疗。比较两组患者治疗3个月后的降糖效果、不良反应及心脑血管事件发生率。结果治疗后观察组血糖峰值、空腹血糖、糖化血红蛋白均显著低于对照组[(10±3) mmol/L比(12±3) mmol/L、(5．9±1．8) mmol/L比(6．4±2．1) mmol/L、(6．3±1．2)%比(7．0±1．3)%](P <0．01)。观察组低血糖发生率为8．3%，低于对照组的23．3%，心脑血管不良事件发生率为8．3%，低于对照组的20．0%，差异有统计学意义(P<0．01)。结论近日节律法给予社区T2DM患者个性化的时间生物性降糖药物治疗，能降低血糖高峰、回避血糖低谷，有效降低患者不良反应及心脑血管事件发生率。
목적：탐토근일절율법구복강당약물간예2형당뇨병( T2DM)환자적림상효과급안전성。방법선취2013년4~7월동완시사전의원수치적120례사구T2DM환자위연구대상，의거수궤수자표법분위대조조화관찰조，각60례。대조조급여상규이갑쌍고0．5 g삼찬전구복치료，관찰조급여혈당감측，조도매례환자특유적혈당근일절률규칙，제정개성화정시약물치료。비교량조환자치료3개월후적강당효과、불량반응급심뇌혈관사건발생솔。결과치료후관찰조혈당봉치、공복혈당、당화혈홍단백균현저저우대조조[(10±3) mmol/L비(12±3) mmol/L、(5．9±1．8) mmol/L비(6．4±2．1) mmol/L、(6．3±1．2)%비(7．0±1．3)%](P <0．01)。관찰조저혈당발생솔위8．3%，저우대조조적23．3%，심뇌혈관불량사건발생솔위8．3%，저우대조조적20．0%，차이유통계학의의(P<0．01)。결론근일절율법급여사구T2DM환자개성화적시간생물성강당약물치료，능강저혈당고봉、회피혈당저곡，유효강저환자불량반응급심뇌혈관사건발생솔。
Objective To discuss the clinical effect and safety of recent rhythm method for the treatment of type 2 diabetes mellitus (T2DM) by oral hypoglycemic drug. Methods From Dongguan Shatin Hospital during April and July 2013,120 T2DM cases were included,the patients were randomly divided into observa-tion group and control group according to random number table method,60 cases in each group. The control group received conventional metformin 0. 5 g,orally before three meals,the observation group was given blood glucose monitoring,and the recent blood glucose rhythm rules of each patient was found out,and individual-ized medication timing was made. The hypoglycemic effect, the adverse reactions and cardiovascular event rate of the two groups were compared three months later. Results After treatment blood glucose peak,fasting blood glucose, glycosylated hemoglobin of the observation group were significantly lower than the control group[(10±3)mmol/Lvs(12±3)mmol/L,(5.9±1.8)mmol/Lvs(6.4±2.1)mmol/L,(6.3± 1.2)% vs(7.0±1.3)%] (P<0.01),Thehypoglycemiaoftheobservationgroupwas8.3%,lowerthan the 23. 3% of the control group, the incidence of cardiovascular and cerebrovascular adverse events was 8.3%,lowerthanthe20.0% ofthecontrolgroup,thedifferenceswerestatisticallysignificant(P<0.01). Conclusion Recent rhythm method to assist make the hypoglycemic medication timing plan for T2DM patients can reduce blood sugar peaks,avoid sugar trough,thus effectively reduce the incidence of adverse reactions and cardiovascular events.