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| 药物减重对肥胖型2型糖尿病的治疗作用 |
| 吴坚,竺春玲,王黎霞,邵筱宏,邹大进,WUJian,ZHUChun-ling,WANGLi-xia,SHAOXiao-hong,ZOUDa-jin |
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| 摘要: |
| 目的:评估减肥药物西布曲明治疗肥胖型2型糖尿病患者的有效性和耐受性. 方法:采用随机、对照研究,选择40例口服降糖药疗效差的肥胖型2型糖尿病患者,体质量指数(BMI)≥25 kg/m2,随机分为西布曲明组及对照组,每组20例.两组均予低热量饮食(低于每天平均摄入热量的1 045～2 090 kJ)并维持原治疗方案,在此基础上西布曲明组加用西布曲明15 mg/d治疗12周.在治疗前后分别测BMI、空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1C)、三酰甘油(TG)、总胆固醇(TC),用稳态模式胰岛素指数(HOMA-IR)评价胰岛素抵抗. 结果:治疗后西布曲明组BMI、FBG、HbA1C、TG、FINS、HOMA-IR较前明显下降(P<0.01);平均体质量下降的百分率与血糖及TG下降的程度呈正相关(P均<0.01),治疗后体质量下降≥5％者4例,其HbA1C和TG也下降明显;不良反应轻微.而对照组治疗前后上述指标均无显著变化.结论:在低热量饮食的基础上,西布曲明不仅可以降低肥胖型2型糖尿病患者的体质量,而且可以改善其代谢控制状况及胰岛素敏感性,耐受性好,且无明显不良反应. |
| 关键词: 西布曲明、糖尿病,2型、治疗结果 |
| DOI：10.3724/SP.J.1008.2006.00531 |
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| Pharmacotherapeutic weight loss in treatment of overweight type 2 diabetes patients |
| 吴坚,竺春玲,王黎霞,邵筱宏,邹大进,WU Jian,ZHU Chun-ling,WANG Li-xia,SHAO Xiao-hong,ZOU Da-jin |
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| Abstract: |
| Objective：To assess the efficacy and tolerability of sibutramine as a weight reduction agent in treatment of overweight patients with type 2 diebetes. Methods： Forty overweight patients （body mass index ≥25 kg/m^2） with type 2 diebetes were randomized into sibutramine treatment group and control group（n= 20）. Both groups received a reduced-calorie diet （deficit of 1 045-2 090 kJ/d from an average daily intake） and continued their original treatment; sibutramine treatment group was also given sibutramine 15 mg once daily for 12 weeks. Before and after sibutramine treatment, body mass index （BMI）, fasting blood glucose （FBG）, fasting serum insulin （FINS）, hemoglobin Alc（ HbAlc ）, and serum lipids were measured in the patients. Homeostasis model assessment （HOMA） was applied to assess the status of insulin resistance （IR）. Results： After treatment, BMI, FBG, H bAlc, TG, FINS and H OMA-IR all decreased （P〈0.01） in sibutramine treatment group. Also in sibutramine treatment group the changes in FBG and TG were correlated with percentage change in body weight （P〈0.01）. Four patients in sibutramine treatment group had a ≥5% weight loss and great decreases in HbAlc and TG. Mild adverse events were no- ticed. Control group had no significant difference in every measurement before and after treatment. Conclusion： Sibutramine can produce significant weight loss in overweight type 2 diabetes patients when used with a reduced-calorie diet; this weight loss is associated with improvement of metabolic control and insulin sensibility. Meanwhile, sibutramine is well tolerated and has less adverse reaction. |
| Key words: sibutramin diebetes mellitlls,type 2 treatment outcome |
